CAJ | 학술논문

目的评价颈动脉狭窄合并糖尿病患者接受颈动脉内膜剥脱术(CEA)的围手术期风险及疗效.方法回顾性分析2010年12月至2013年12月行CEA治疗的148例颈动脉狭窄患者的临床资料;按是否伴发糖尿病分为糖尿病组(n=83)和非糖尿病组(n=65);比较2组病例的年龄、性别、危险因素、术中情况、术后并发症、1年后再狭窄率.结果 2组患者的一般资料、临床症状、伴随疾病、手术时间、出血量、术中转流等差异均无统计学意义(均P＞0.05).糖尿病组术后感染、颈部血肿、颅神经损伤、心肌梗死、术后脑梗死、高灌注综合征、全因死亡发生率及1年后再狭窄率分别为7.2%、12.0%、10.8%、3.6%、6.0%、9.6％、2.4%、9.6%,非糖尿病组分别为3.1％、9.2%、4.6%、1.5%、4.6%、7.7%、1.5%、3.1%,差异均无统计学意义(x2 =0.551、0.300、1.898、0.069、0、0.172、0.138、1.559,均P＞0.05).结论颈动脉狭窄合并糖尿病的患者在严格控制血糖、术前充分评估心脑血管状况并提前干预情况下,可以接受CEA手术.
목적 평개경동맥협착합병당뇨병환자접수경동맥내막박탈술(CEA)적위수술기풍험급료효.방법 회고성분석2010년12월지2013년12월행CEA치료적148례경동맥협착환자적림상자료;안시부반발당뇨병분위당뇨병조(n=83)화비당뇨병조(n=65);비교2조병례적년령、성별、위험인소、술중정황、술후병발증、1년후재협착솔.결과 2조환자적일반자료、림상증상、반수질병、수술시간、출혈량、술중전류등차이균무통계학의의(균P＞0.05).당뇨병조술후감염、경부혈종、로신경손상、심기경사、술후뇌경사、고관주종합정、전인사망발생솔급1년후재협착솔분별위7.2%、12.0%、10.8%、3.6%、6.0%、9.6％、2.4%、9.6%,비당뇨병조분별위3.1％、9.2%、4.6%、1.5%、4.6%、7.7%、1.5%、3.1%,차이균무통계학의의(x2 =0.551、0.300、1.898、0.069、0、0.172、0.138、1.559,균P＞0.05).결론 경동맥협착합병당뇨병적환자재엄격공제혈당、술전충분평고심뇌혈관상황병제전간예정황하,가이접수CEA수술.
Objective To evaluate the perioperative complications and effectiveness of carotid endarterectomy (CEA) with diabetes mellitus (DM).Methods A total of 148 patients with carotid stenosis undergone CEA from December 2010 to December 2013 were collected and analyzed retrospectively.The patients were distributed into DM group (n =83) and the control group (n =65) according to the comorbidities.Age, gender, risk factors, stenosis degree, cerebral ischemic symptom, shunt in operation, perioperative complications and restenosis after one year in the two groups were analyzed and compared.Results There were no statistical difference between the two groups in terms of the general characteristic, clinical ischemic symptoms, concomitant disease, operative time, the amount of bleeding, the ratio of shunt (P ＞ 0.05).The rates of perioperative complications observed in DM group, including postoperative infection, neck hematoma, cranial nerves injured, acute cardiac infarction, stroke, hyperperfusion syndrome, all-cause mortality and one year restenosis after operation were 7.2%, 12.0%, 10.8% ,3.6%, 6.0% ,9.6% ,2.4% and 9.6% respectively.The complication rates observed in the control group, on the other hand were 3.1% ,9.2% ,4.6% ,1.5% ,4.6% ,7.7%, 1.5% and 3.1% respectively.There were no significant statistical difference between the two groups (x2 =0.551, 0.300, 1.898, 0.069, 0, 0.172, 0.138, 1.559,P ＞ 0.05).Conclusion CEA may be safe and effective in diabetic patients suffering from carotid stenosis, on the condition that the blood glucoses of the patients are controlled well, and the cardio cerebral vascular system is carefully assessed and intervened before the operation.