河南外科学杂志
河南外科學雜誌
하남외과학잡지
HENAN JOURNAL OF SURGERY
2015年
3期
5-8
,共4页
王颖%王兵%王洛波%李攀峰%崔文军%吴斐%司江涛
王穎%王兵%王洛波%李攀峰%崔文軍%吳斐%司江濤
왕영%왕병%왕락파%리반봉%최문군%오비%사강도
颈动脉内膜剥脱术%颈动脉狭窄%转流管%脑卒中
頸動脈內膜剝脫術%頸動脈狹窄%轉流管%腦卒中
경동맥내막박탈술%경동맥협착%전류관%뇌졸중
Carotid endarterectomy%Carotid stenosis%Shunting%Stroke
目的:探讨颈动脉内膜剥脱术(carotid endarterectomy,CEA)治疗一侧颈动脉重度狭窄伴对侧颈动脉轻-中度及重度狭窄患者不使用转流管的安全性。方法回顾性分析138例一侧颈动脉重度狭窄伴对侧颈动脉不同程度狭窄患者的临床资料,其中对侧颈动脉轻-中度狭窄组95例(A 组),对侧颈动脉重度狭窄组43例(B 组)。随访 CEA 后30 d 内2组患者心脏、术侧新发脑卒中等并发症和病死率。评估对侧颈动脉狭窄的程度对不使用转流管 CEA 的安全性的影响。结果138例患者均成功实施 CEA,术中均未使用转流管。术后30 d 内 A 组出现2例(2.11%)心脏并发症,3例(3.16%)脑卒中,1例(1.05%)死亡。B 组出现2例(4.65%)心脏并发症,1例(2.33%)脑卒中,无死亡病例。2组各不良事件比较差异无统计学意义(P =1.000,P =0.781,P =1.000)。总的主要不良事件发生率为6.5%,卒中及病死率为3.6%。结论不使用转流管 CEA 治疗双侧颈动脉狭窄,安全、有效,随着对侧颈动脉狭窄程度增加并不增加围手术期脑卒中和死亡风险。
目的:探討頸動脈內膜剝脫術(carotid endarterectomy,CEA)治療一側頸動脈重度狹窄伴對側頸動脈輕-中度及重度狹窄患者不使用轉流管的安全性。方法迴顧性分析138例一側頸動脈重度狹窄伴對側頸動脈不同程度狹窄患者的臨床資料,其中對側頸動脈輕-中度狹窄組95例(A 組),對側頸動脈重度狹窄組43例(B 組)。隨訪 CEA 後30 d 內2組患者心髒、術側新髮腦卒中等併髮癥和病死率。評估對側頸動脈狹窄的程度對不使用轉流管 CEA 的安全性的影響。結果138例患者均成功實施 CEA,術中均未使用轉流管。術後30 d 內 A 組齣現2例(2.11%)心髒併髮癥,3例(3.16%)腦卒中,1例(1.05%)死亡。B 組齣現2例(4.65%)心髒併髮癥,1例(2.33%)腦卒中,無死亡病例。2組各不良事件比較差異無統計學意義(P =1.000,P =0.781,P =1.000)。總的主要不良事件髮生率為6.5%,卒中及病死率為3.6%。結論不使用轉流管 CEA 治療雙側頸動脈狹窄,安全、有效,隨著對側頸動脈狹窄程度增加併不增加圍手術期腦卒中和死亡風險。
목적:탐토경동맥내막박탈술(carotid endarterectomy,CEA)치료일측경동맥중도협착반대측경동맥경-중도급중도협착환자불사용전류관적안전성。방법회고성분석138례일측경동맥중도협착반대측경동맥불동정도협착환자적림상자료,기중대측경동맥경-중도협착조95례(A 조),대측경동맥중도협착조43례(B 조)。수방 CEA 후30 d 내2조환자심장、술측신발뇌졸중등병발증화병사솔。평고대측경동맥협착적정도대불사용전류관 CEA 적안전성적영향。결과138례환자균성공실시 CEA,술중균미사용전류관。술후30 d 내 A 조출현2례(2.11%)심장병발증,3례(3.16%)뇌졸중,1례(1.05%)사망。B 조출현2례(4.65%)심장병발증,1례(2.33%)뇌졸중,무사망병례。2조각불량사건비교차이무통계학의의(P =1.000,P =0.781,P =1.000)。총적주요불량사건발생솔위6.5%,졸중급병사솔위3.6%。결론불사용전류관 CEA 치료쌍측경동맥협착,안전、유효,수착대측경동맥협착정도증가병불증가위수술기뇌졸중화사망풍험。
Objective To investigate the safety without shunting during carotid endarterectomy for severe carotid stenosis patients with contralateral carotid normal、light - moderate or severe stenosis. Methods Retrospectively analyze the clinical data of 138 severe carotid steno-sis patients with contralateral carotid light - moderate and severe stenosis,divided to group A(95 cases)and group B(43 cases)based on de-gree of stenosis . To record cardiac complications、new stroke of operation side、death within postoperative 30 days after CEA were performed. Results The success rate of surgical cases was 100% ,CEAs were performed without shunting. Within postoperative 30 days after CEA were performed,2 cases(2. 11% )occurred cardiac complications,3 cases(3. 16% )occurred stroke,1 case(1. 05% )died in the group A,and 2 cases(4. 65% )occurred cardiac complications,1 case(2. 33% )occurred stroke,no death occurred in the group B. There were no significant differences in major adverse events in both groups( P = 1. 000,P = 0. 781,P = 1. 000). The total major adverse events rate was 6. 5% ,stroke and death rate was 3. 6% . Conclusion CEA without shunting is secure for severe carotid stenosis patients with contralateral carotid light - moderate or severe stenosis. With increasing stenosis grade of contralateral carotid will not increase the risk of stroke and death.