[1]秦海林　秦　汉　安学锋　別毕洲.颈动脉内膜斑块剥脱术治疗颈内动脉重度狭窄[J].中国临床神经外科杂志,2018,(12):775-778.[doi:10.13798/j.issn.1009-153X.2018.12.003]
　QIN Hai-lin,QIN Han,AN Xue-feng,et al.Effect of carotid endarterectomy on patients with severe stenosis of internal carotid artery[J].,2018,(12):775-778.[doi:10.13798/j.issn.1009-153X.2018.12.003]
点击复制

颈动脉内膜斑块剥脱术治疗颈内动脉重度狭窄()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年12期
页码:
775-778
栏目:
论著
出版日期:
2018-12-25

文章信息/Info

Title:
Effect of carotid endarterectomy on patients with severe stenosis of internal carotid artery
文章编号:
1009-153X（2018）12-0775-04
作者:
秦海林　秦　汉　安学锋　別毕洲
430070 武汉，中国人民解放军中部战区总医院神经外科（秦海林、秦　汉、安学锋）；430032 武汉，湖北省第三医院神经外科（別毕洲）
Author(s):
QIN Hai-lin1;  QIN Han1;  AN Xue-feng1;  BIE Bi-zhou2.
1. Department of Neurosurgery, General Hospital, Central Command, PLA, Wuhan 430070, China; 2. Department of Neurosurgery, The Third People’s Hospital of Hubei Province, Wuham 430032, China
关键词:
缺血性脑卒中; 颈内动脉狭窄; 颈动脉内膜斑块剥脱术; 疗效
Keywords:
carotid endarterectomy(CEA) ischemic stroke internal carotid stenosis
分类号:
R743;R651.1+2
DOI:
10.13798/j.issn.1009-153X.2018.12.003
文献标志码:
A
摘要:
目的 探讨颈动脉内膜斑块剥脱术在颈内动脉重度狭窄治疗中的临床应用价值。方法 回顾性分析2016年5月至2018年11月在我院神经外科实施颈动脉内膜斑块剥脱术治疗的40例颈内动脉重度狭窄的临床资料。所有病人经颈动脉超声多普勒、头颈部CTA或DSA诊断为颈内动脉重度狭窄。结果 所有病人均顺利完成手术，术后无脑梗死、死亡。1例术后出现短暂性脑缺血发作，4 h内恢复；1例有鼻咽癌放疗史，术后吻合口渗血，经二次手术后完全恢复。术后随访1~20个月，所有病人血管通畅、狭窄解除，无脑血管事件发生。结论 颈动脉内膜斑块剥脱术是治疗颈内动脉重度狭窄简单、安全、有效的方法，对防治缺血性脑卒中有重要意义。
Abstract:
Objective To investigate the clinical value of carotid endarterectomy (CEA) to the treatment of severe stenosis of internal carotid artery (ICA). Methods The clinical data of 40 patients with severe stenosis of ICA, who underwent CEA in neurosurgery department of our hospital from May, 2016 to November, 2018, were analyzed retrospectively. All the patients were diagnosed as severe carotid stenosis by carotid ultrasonography, and craniocervical CTA or DSA. Results The surgeries were successfully performed in all the patients. No postoperative cerebral infarction and death occurred in all the patients. One patient with transient ischemic attack after CEA was recovered from the attack within 4 hours after the attack. One patient with posteroperative ooze of blood out of the margin of the anastomosis, who had the history of radiotherapy for nasopharyngeal carcinoma, underwent the operative repair of the margin of the anatomosis. The following up from 1 to 20 months after the CEA showed that all the vessels were free without stenosis and no cerebral ischemia occurred in all the patients. Conclusions CEA is a simple, safe and effective method to treat the severe carotid stenosis, and it is of important value to the preventing and treating the cerebral ischemic stroke.

参考文献/References:

[1] 闫忠军，徐东为，胡　焱，等. 急性缺血性脑卒中的治疗体会[J]. 中国临床神经外科杂志，2017，22（8）：591-592.
[2] 董　辉，张　晖，蔡　磊，等. 颈动脉内膜斑块剥脱术治疗体会[J]. 中国临床神经外科杂志，2017，22（8）：587-588.
[3] 宋　平，陈晓斌，杜　浩，等. 内膜斑块剥脱术治疗颈动脉狭窄的临床分析[J]. 中国临床神经外科杂志，2016，21（9）：527-529.
[4] 张鹏飞，赵立文，汪子文，等. 内膜斑块剥脱术与支架置入术治疗颈动脉狭窄的Meta分析[J]. 中国临床神经外科杂志，2016，21（8）：455-457.
[5] Kernan WN, Ovbiagele B, Black HR, et al. Guidelines for the prevention of stroke in patients with stroke and transientischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association [J]. Stroke, 2014, 45(7): 2160-236.
[6] Barnett HJ, Taylor DW, Eliasziw M, et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis: North American Symptomatic Carotid Endarterectomy Trial Collaborators [J]. N Engl J Med, 1998,339(20): 1415-1425.
[7] European Carotid Surgery Trialists’ Collaborative Group. Randomised trial of endarterectomy for recently symptoma-tic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST) [J]. Lancet, 1998, 351(9113):1379-1387.
[8] Littooy FN, Gagovic V, Sandu C, et al. Comparison of stan-dard carotid endarterectomy with Dacron patch angioplasty versus eversion carotid endarterectomy during a 4-year period [J]. Am Surg, 2004, 70(2): 181-185.
[9] Musicant SE, Guzzetta VJ, Terramani TT, et al. Modified eversion carotid endarterectomy (mECEA): analysis of clinical and financial outcomes [J]. Ann Vasc Surg, 2017,42: 16-24.
[10] Mendon?a CT, Fortunato JA Jr, Carvalho CA, et al. Carotid endarterectomy in awake patients: safety, tolerability and results [J]. Rev Bras Cir Cardiovasc, 2014, 29(4): 574-580.
[11] Lam AM, Kianpour D. Monitoring for carotid endarterecto-my: more or less [J]? Anesth Analg, 2015, 120(6): 1186-1188.
[12] Chang JW, Kim SW, Lee S, et al. Dual monitoring with stump pressure and electroencephalography during carotid endarterectomy [J]. Korean J Thorac Cardiovasc Surg, 2017,50(2): 94-98.
[13] Findlay JM, Kesarwani R, Jacka M, et al. Combined stump pressure and oximetry for shunt use during carotid endar-terectomy [J]. Can J Neurol Sci, 2017, 44(6): 692-696.
[14] Almefty RO, Spetzler RF. Avoiding complications aftercarotid endarterectomy [J]. World Neurosurg, 2014, 82(6):e699-e700.[15] 唐　冬，陈金华，陈　涛，等. 颈动脉内膜斑块剥脱术横向与纵向皮肤切口术后颅神经损伤比较[J]. 中国临床神经外科杂志，2016，21（11）：696-697.
[16] 白　鹏，李寒阳，李正迁，等. 颈动脉内膜斑块切除术中血压调控水平与术后不良事件的关系[J]. 中国临床神经外科杂志，2017，22（4）：216-218.

相似文献/References:

[1]宋　平　陈晓斌　杜　浩　蔡　强　罗　明　阮　航　吴京雷　段发亮.内膜斑块剥脱术治疗颈动脉狭窄的临床分析[J].中国临床神经外科杂志,2016,(09):527.[doi:10.13798/j.issn.1009-153X.2016.09.006]
　SONG Ping,CHEN Xiao-bin,DU Hao,et al.Clinical analysis of carotid endarterectomy for ischemic stroke[J].,2016,(12):527.[doi:10.13798/j.issn.1009-153X.2016.09.006]
[2]汪晓玲　倪志福　王云甫.依达拉奉联合氯吡格雷治疗老年缺血性脑卒中的效果与安全性分析[J].中国临床神经外科杂志,2017,(04):222.[doi:10.13798/j.issn.1009-153X.2017.04.005]
　WANG Xiao-ling,NI Zhi-fu,WANG Yun-fu..Curative effect of edaravone combined with clopidogrel on ischemic stroke and its safety in the elderly patients[J].,2017,(12):222.[doi:10.13798/j.issn.1009-153X.2017.04.005]
[3]段发亮,黄从刚,倪厚杰,等.阿司匹林联合氯吡格雷治疗缺血性脑卒中的疗效及对血小板聚集率的影响[J].中国临床神经外科杂志,2017,(07):470.[doi:10.13798/j.issn.1009-153X.2017.07.008]
　DUAN Fa-liang,HUANG Cong-gang,NI Hou-jie,et al.Curative effect of aspirin combined with plavix on ischemic stroke and its impact on platelet aggregation rate[J].,2017,(12):470.[doi:10.13798/j.issn.1009-153X.2017.07.008]
[4]王谋龙　李爱红　曲良锁.血清ANP水平及ANP基因多态性与缺血性脑卒中相关性的Meta分析[J].中国临床神经外科杂志,2018,(03):161.[doi:10.13798/j.issn.1009-153X.2018.03.007]
　WANG Mou-long,LI Ai-hong,QU Liang-suo.Meta-analysis of relativity of ANP serum levels and genetic polymorphisms with ischemic stroke risk[J].,2018,(12):161.[doi:10.13798/j.issn.1009-153X.2018.03.007]
[5]徐东为　赵振伟　李　江　闫忠军　屈　延　高国栋.急性前循环脑动脉闭塞支架成形术的疗效[J].中国临床神经外科杂志,2018,(05):328.[doi:10.13798/j.issn.1009-153X.2018.05.008]
　XU Dong-wei,ZHAO Zhen-wei,LI Jiang,et al.Effect of stenting on acute cerebral artery occlusion in anterior circulation[J].,2018,(12):328.[doi:10.13798/j.issn.1009-153X.2018.05.008]
[6]徐　阳　刘宝辉　袁凡恩　刘骏辉　许鹏飞　陈谦学.小胶质细胞在缺血性脑卒中中作用机制的研究进展[J].中国临床神经外科杂志,2018,(07):503.[doi:10.13798/j.issn.1009-153X.2018.07.020]
[7]晁晓峰　谢满意　陈洪福　李中林　于如同.颈外动脉缺如并颈内动脉狭窄1例[J].中国临床神经外科杂志,2019,(01):63.[doi:10.13798/j.issn.1009-153X.2019.01.021]
[8]杨晓波.基于放松训练的情志护理对缺血性脑卒中病人锻炼依从性的影响[J].中国临床神经外科杂志,2019,(04):242.[doi:10.13798/j.issn.1009-153X.2019.04.019]
[9]陈　玲　赵振伟　张登文　方　伟　樊　霞　翟君丽　郎红娟.目标化康复指导路径表单在脑卒中病人早期康复中的应用[J].中国临床神经外科杂志,2019,(10):631.[doi:10.13798/j.issn.1009-153X.2019.10.018]
[10]马继伟　赵新利　赵树鹏　梁书锋　申法政　周文科　张新中.成人缺血型烟雾病的联合脑血运重建术治疗[J].中国临床神经外科杂志,2020,(01):38.[doi:10.13798/j.issn.1009-153X.2020.01.013]

备注/Memo

备注/Memo:
doi:10.13798/j.issn.1009-153X.2018.12.003 作者单位：430070 武汉，中国人民解放军中部战区总医院神经外科（秦海林、秦　汉、安学锋）；430032 武汉，湖北省第三医院神经外科（別毕洲）
更新日期/Last Update: 2018-12-26