老年人颈动脉内膜切除术61例临床分析

Clinical study on carotid endarterectomy in 61 elderly patients

目的 评价老年症状性颈动脉狭窄患者行颈动脉内膜切除术的疗效和安全性。 方法 回顾性分析 6 1例老年症状性颈动脉狭窄患者行颈动脉内膜切除术的临床资料。 结果 全组无死亡病例 ,脑缺血症状明显改善 4 5例 ,好转 13例 ,术后并发脑梗死 2例 ,颈动脉内血栓形成 1例。 5 5例随访 1～ 18个月 ( 4 0例随访时间≥ 12个月 ) ,5 3例病情稳定 ,2例有短暂性脑缺血发作。 结论 只要适应证选择准确 ,围术期处理得当 ,术中操作熟练 ,颈动脉内膜切除术对老年人是安全、有效的。

Objective To study the clinical results and safety of carotid endarterectomy (CEA) in the elderly patients. Methods The clinical data of 61 elderly patients with symptomatic carotid stenosis who underwent CEA were reviewed retrospectively. Forty nine male, 12 female, aged 61 84 years(mean 71 5). All patients with carotid stenosis were diagnosed by carotid artery Doppler ultrasonography and DSA. General anesthesia was adopted in 29 cases and regional anesthesia in 32 cases. Temporary intraluminal shunts were applied in 50 patients. Results There was no death in the early stage of postoperation, the chronic symptoms of cerebral ischemia was obviously improved in 45 cases and improved in 13 cases; while serious postoperative complications were observed in 3 patients who underwent CEA, including 2 cerebral ischemia, 1 internal carotid thrombosis. Follow up for 1 18 months showed a stable general condition in 53 cases, and TIA attact in 2 cases. Conclusions CEA is an effective and safe method in treating the symptomatic carotid artery stenosis for the elderly patients under the strict selection of indications,proper intensive care during pre and post operation,and skillful operation technique.