颈动脉内膜切除术中应用临时转流管的疗效探讨

Using vascular shunt in carotid endarterectomy

目的 探讨颈动脉内膜切除术中应用颈动脉临时转流管的指征和经验 方法 对 42例颈动脉狭窄患者行颈动脉内膜切除术,术中使用经颅多普勒超声监测大脑中动脉血流速度, 8例患者阻断术侧颈内动脉后,大脑中动脉血流速度低于阻断前的60%,对此8例患者使用颈动 脉临时转流管,术后随访1～24个月。 结果 使用颈动脉临时转流管的8例患者,未出现与阻 断颈内动脉有关的围手术期并发症;随访期内无再次脑缺血事件发生;颈部B超检查显示颈动脉 通畅,无再狭窄发生。 结论 颈动脉内膜切除术中有选择性地使用颈动脉临时转流管,可预防 与阻断术侧颈内动脉有关的术中脑缺血事件的发生。

Objective To investigate the indication of using vascular shunt in carotid endarterectomy. Methods Average velocity of blood flow in middle cerebral artery was measured during the surgery in 42 cases. Lower than 60% of average blood flow speed in middle cerebral artery after carotid artery occlusion was found in 8 cases. Therefore, vascushunt was used in 8 cases. Results There was no complications about carotid artery occlusion during operation. There was no cerebral ischemia attack during period of follow-up study. Ultrasonic examination in follow-up showed that carotid artery kept patent, no restenosis was found. Conclusion Using vascushunt selectively in carotid endarterectomy may prevent cerebral ischemic accident due to intraoperative carotid artery occlusion.