[1]秦海林　胡军民　秦　汉　安学锋.颈动脉内膜斑块剥脱术后缺血型脑卒中的防治[J].中国临床神经外科杂志,2020,(11):743-745.[doi:doi:10.13798/j.issn.1009-153X.2020.11.003]
　QIN Hai-lin,HU Jun-min,QIN Han,et al.Prevention of postoperative ischemic stroke in patients undergoing carotid endarterectomy[J].,2020,(11):743-745.[doi:doi:10.13798/j.issn.1009-153X.2020.11.003]
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颈动脉内膜斑块剥脱术后缺血型脑卒中的防治()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年11期
页码:
743-745
栏目:
论著
出版日期:
2020-11-25

文章信息/Info

Title:
Prevention of postoperative ischemic stroke in patients undergoing carotid endarterectomy
文章编号:
1009-153X（2020）11-0743-03
作者:
秦海林　胡军民　秦　汉　安学锋
430070 武汉，中国人民解放军中部战区总医院神经外科（秦海林、胡军民、秦　汉、安学锋）
Author(s):
QIN Hai-lin;  HU Jun-min;  QIN Han;  AN Xue-feng.
Deparment of Neurosurgery, General Hospital of Central Theater Command, PLA, Wuhan 430070, China
关键词:
颈动脉内膜斑块剥脱术; 缺血性脑卒中; 防治方法
Keywords:
Carotid endarterectomy;  Postoperative ischemic stroke;  Prevention
分类号:
R 743; R 651.1+2
DOI:
doi:10.13798/j.issn.1009-153X.2020.11.003
文献标志码:
A
摘要:
目的 探讨颈动脉内膜斑块剥脱术后缺血性脑卒中的防治方法。方法 回顾性分析2016年5月至2019年11月颈动脉内膜斑块剥脱术治疗的70例颈动脉狭窄的临床资料。术前行颈动脉彩色多普勒超声、头颈部血管CTA或DSA检查，术中严格落实各项卒中预防措施，包括平稳控制血压，轻柔精细操作，顺序解剖、阻断、开放各血管，仔细清理斑块、内膜远端固定、严密缝合，返流压、体感诱发电位联合监测等。结果 2例（2.86%）术后出现脑缺血事件。无心肌梗死、手术死亡病例。术后随访3~30个月，所有病人血管通畅、无狭窄，恢复良好。结论 轻柔精准操作、平稳控制血压、多项目监测等对防治颈动脉内膜斑块剥脱术后缺血性脑卒中有重要意义。
Abstract:
Objective To investigate the methods to prevent postoperative ischemic stroke in the patients undergoing carotid endarterectomy (CEA). Methods The clinical data of 70 patients who underwent CEA from May 2016 to November 2019 were analyzed retrospectively. The carotid ultrasonography, CTA or DSA were performed in all the patients before the operation. Stroke prevention measures were strictly implemented during the operation, including controlling the blood pressure smoothly, operating gently and delicately, sequential dissection, blocking, and opening of the blood vessels, injecting heparin and flushing the operation area with diluted heparin, cleaning the plaque carefully, fixing the distal end of intima, tightly sewing the patch, and using monitoring of stump pressure and somatosensory evoked potential and so on. Results All the surgeries were successful. Ischemic stroke occurred in 2 patients (2.86%) after the operation. There was no postoperative cardiac infarction or death. The follow-up (range, 3~30 months) results showed that all the patients were recovered well and the carotid artery patencies without stenoses were preserved in all the patients. Conclusions Gentle and precise operation, stable control of blood pressure and multi-modal monitoring during the operation are of great significance to the prevention of postoperative ischemic stroke in the patients undergoing CEA.

参考文献/References:

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更新日期/Last Update: 2020-11-25