颈动与脉内膜剥脱术防治缺血性脑卒中的临床研究.pdfVIP

《中国医学前沿杂志 （电子版）》2012年第4卷第6期 ● 临床研究 ● 33 颈动脉内膜剥脱术防治缺血性脑卒中的 临床研究 1 1 2 3 1 1 1 1 包文 ，段永亮 ，管圣 ，杨旭 ，刘小庆 ，冯涛 ，王宏 ，马建军 （1．新疆医科大学附属中医医院　普外 科，乌鲁木齐 830000；2．新疆自治区人民医院 普外二科，乌鲁木齐 830001；3．新疆医科大学第二附 属医院 普外科，乌鲁木齐 830028） 【摘要】目的 总结颈动脉内膜剥脱术防治颈动脉硬化性狭窄引起的缺血性脑卒中的临床应用。方法 回顾性分析200 1年11月～20 12年1月间对147侧 （139例）颈动脉狭窄病变实施内膜剥脱术治疗的临床 资料。结果 本组中，87% 的患者采用颈丛麻醉，92% 的患者颈动脉内膜剥脱后应用补片血管成形， 11例患者术中放置临时性转流管，2例患者为颈动脉支架失败后改行颈动脉内膜剥脱术 （CEA ）。术 后轻度神经损伤7例，占4.8% ；1例于术后3天出现偏瘫，占0.7% ；全组无围术期死亡病例。临床随访 123例，随访率为88.5% ，平均随访39 ±4个月。术后患者脑缺血症状消失或明显改善97例，占66% ； 症状改善、好转者19例，占12.9% ；术后颈动脉再狭窄发生24例 （均＜50% ），占16.3% 。结论 颈动 脉内膜剥脱术疗效肯定，值得推广应用。 【关键词】颈动脉狭窄；脑卒中；颈动脉内膜剥脱术 Clinical study of prevention and treatment in patients of ischemia stroke with carotid endarterectomy BAO Wen, DUAN Yong-liang, GUAN Sheng, et al. Department of General Surgery, Affiliated Chinese Traditional Medical Hospital of Xinjiang Medical University, Urumqi 830000, China Corresponding author: BAO Wen, Email: baowen1023@yahoo.cn Abstract Objective To conclude the clinical usage in preventing and treating patients of carotid artery 【 】 ischemia stenosis with carotid endarterectomy. Methods To review the data of 147 sides (139 patients) of carotid artery ischemia stenosis with carotid endarterectomy from the November in 2001 to the January in 2012. Result 87% of patients were received anesthetics of regional cervical plexus blocks. 92% of patients were given patches in CEA. Shunts were used in 11 patients and 2 patient were performed with CEA after failures of carotid stent placements of them. 7 cases (4.8%) got injured of nerves from operations. One stroke (0.7%) happened 3 days after his CEA. There was not any death of the perioperations. 88.5% (123 cases) of the patients were followed up during 39±4 months. Good results were got in patients with the rates of 66% in 97 cases improved