颈总动脉切除术10例回顾性分析

Retrospective analysis of 10 cases of carotid resection

目的 探讨颈总动脉切除术的适应症和术前准备的一般规律。方法 对我院自 1986年～ 2 0 0 3年 17年间的 10例颈总动脉切除术病例进行回顾性分析。其中年龄 2 2～ 5 9岁 ,急诊手术 4例 ,选择性颈动脉切除 6例。结果 急诊手术中 2例出现中枢神经系统并发症 ,选择性手术组中 1例出现中枢神经系统并发症。除 1例因脑转移癌死亡外 ,随访均健在。结论 行不重建血管的颈总动脉及分歧部切除术 ,高龄患者须严格掌握适应症 ,须无脑血管疾病史 ,术前须进行 Matas试验 ,要有侧支循环建立的客观依据 ;对年轻患者 (30岁以下 )可适当放宽手术指征。

Objective To evaluate the requirement and the preoperative preparation of carotid resection. To evaluate the requirement and the preoperative preparation of carotid resection. To retrospective study 10 patients with carotid resection during 1986 to 2003.The age of these patients range from 22 to 59 years,in these cases,four of them received emergency operation(without Mata’s straining),the other of six patients received selected carotid resection. In four patients receiving emergency operation,two of them got CNS(central nervous system)complication,in selected operation group,only 1 got CNS complication.Except one patient die from intracranial metastasis,the other nine patients are all survived.[Conclusion] Carotid resection must meet three conditions:the first,the patient has no cerebal vessels malformatiom,the second,must receiving Mata’s training,the third,we must get the testimony of lateral branch circulation built.The great age patient must fit these three conditions strictly.And the young patients(under 30 years)needn’t fit these three terms strictly.