首页> 中文期刊> 《中国临床新医学》 >颈动脉内膜剥脱术对缺血性脑卒中的防治效果分析

颈动脉内膜剥脱术对缺血性脑卒中的防治效果分析

         

摘要

Objective To summarize the experience of carotid endarterectomy in prevention and treatment of the ischemic stroke .Methods From October 2001 to December 2011 , 196 patients with unilateral internal carotid artery stenosis received carotid endarterectomy .In operation, carotid artery, shunts were applied in 47 cases, bloc-king blood flow in 149 cases.The preoperative carotid angiography showed internal carotid artery stenosis greater than 70%in 133 cases, more than 95%in 63 cases.There were 71 cases to be complicated by coronary artery lesions , 17 cases received coronary artery bypass simultaneously .Results The postoperative clinical symptoms improved in 191 cases, cerebral hemorrhage appeared in 3 cases within 1 week after operation, among them after the hemostatic crani-otomy drainage , 1 case was healed , 2 cases died .In 12 cases hematoma appealed inside cervical incision and were cured by the surgical debridement hemostasis .All cases were followed up for 6 to 60 months, 166 cases received fol-low-up, lost fellow-up in 28 cases, 38 cases died of disaster or ill in a follow-up.There were no attack of cerebral is-chemic symptoms again in128 cases.Conclusion Carotid endarterectomy is an effective and safe treatment for severe carotid artery stenosis .%目的:总结颈动脉内膜剥脱术对防治缺血性脑卒中的经验。方法对196例患者进行颈动脉内膜剥脱术,均为单侧。术中应用颈动脉转流管47例,阻断血流149例。术前均经颈动脉造影检查,选择颈内动脉狭窄>70%者133例,>95%者63例。71例患者并存冠状动脉病变,17例同台行冠状动脉搭桥。结果术后临床症状改善满意191例,术后1周内出现脑出血3例,经开颅止血引流,痊愈1例,死亡2例。出现颈部切口内血肿12例,再手术清创止血获愈。随访6~60个月,获得随访166例,失访28例,死于其他疾病或灾祸38例,无脑缺血症状再发作128例。结论颈动脉内膜剥脱术是治疗颈动脉重度狭窄的一种有效、安全术式。

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