摘要
BACKGROUND： Carotid endarterectomy has certain risks, but it has obvious effects on preventing the occurrence of stroke. OBJECTIVE： To identify the effects of carotid endarterectomy on ameliorating the clinical symptoms and physical signs of patients with cerebral ischemia. DESIGN： A follow-up study. SETTING： Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. PARTICIPANTS： Sixteen patients with carotid atherosclerotic stenosis accompanied by ischemic symptoms were selected from the Department of Vascular Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from March 2005 to May 2007. There were 11 males and 5 females, aged from 40 to 81 years old with a mean age of 60 years old, and they were all clearly diagnosed by carotid color Doppler ultrasound. Informed consent was obtained from all the patients. The study was approved by the hospital ethical committee. METHODS： （1） All the 16 patients were performed with unilateral stripping of arteriosclerotic plaque and Carotid endarterectomy, and 6 of them with bilateral stenosis was operated on the side with more serious stenosis. （2） The clinical symptoms, physical signs before and after operation, and the operative complications were observed. （3） The patients were followed up for 6 months postoperatively. The smoothness of carotid arteries was detected with color Doppler ultrasound. The degrees of satisfaction to the quality of living were evaluated. MAIN OUTCOME MEASURES： （1） Amelioration of clinical symptoms postoperatively; （2） Smoothness of carotid arteries postoperatively; （3） Degrees of satisfaction to the quality of living; （4） Postoperative complications. RESULTS： All the 16 patients were involved in the final analysis of results. （1） Amelioration of clinical symptoms and physical signs： The postoperative muscle strengths of 3 patients with stroke history were significantly ameliorated; For the 8 patients with TIA symptoms, and the symptoms disappeared completely in 6 cases of them; For the 5 patients with atypical nervous symptoms, the symptoms disappeared completely in 3 cases, and obviously alleviated in 2 cases. （2） All the patients were good in smoothness of carotid arteries. （3） The degree of satisfaction to the quality of living was a little satisfied in 2 patients, very satisfied in 1 patient, and satisfied in the others. （4） Postoperative complications： The complications were injury of hypoglossal nerve in 4 patients （25%） and injury of recurrent laryngeal nerve in 1 patient （6%）, and the complications recovered or turned better after conservative treatments for 1 - 3 months. CONCLUSION： Carotid endarterectomy can ameliorate the symptoms and physical signs of patients with cerebral ischemia, and it has mild postoperative complications.
BACKGROUND： Carotid endarterectomy has certain risks, but it has obvious effects on preventing the occurrence of stroke. OBJECTIVE： To identify the effects of carotid endarterectomy on ameliorating the clinical symptoms and physical signs of patients with cerebral ischemia. DESIGN： A follow-up study. SETTING： Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. PARTICIPANTS： Sixteen patients with carotid atherosclerotic stenosis accompanied by ischemic symptoms were selected from the Department of Vascular Surgery, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from March 2005 to May 2007. There were 11 males and 5 females, aged from 40 to 81 years old with a mean age of 60 years old, and they were all clearly diagnosed by carotid color Doppler ultrasound. Informed consent was obtained from all the patients. The study was approved by the hospital ethical committee. METHODS： （1） All the 16 patients were performed with unilateral stripping of arteriosclerotic plaque and Carotid endarterectomy, and 6 of them with bilateral stenosis was operated on the side with more serious stenosis. （2） The clinical symptoms, physical signs before and after operation, and the operative complications were observed. （3） The patients were followed up for 6 months postoperatively. The smoothness of carotid arteries was detected with color Doppler ultrasound. The degrees of satisfaction to the quality of living were evaluated. MAIN OUTCOME MEASURES： （1） Amelioration of clinical symptoms postoperatively; （2） Smoothness of carotid arteries postoperatively; （3） Degrees of satisfaction to the quality of living; （4） Postoperative complications. RESULTS： All the 16 patients were involved in the final analysis of results. （1） Amelioration of clinical symptoms and physical signs： The postoperative muscle strengths of 3 patients with stroke history were significantly ameliorated; For the 8 patients with TIA symptoms, and the symptoms disappeared completely in 6 cases of them; For the 5 patients with atypical nervous symptoms, the symptoms disappeared completely in 3 cases, and obviously alleviated in 2 cases. （2） All the patients were good in smoothness of carotid arteries. （3） The degree of satisfaction to the quality of living was a little satisfied in 2 patients, very satisfied in 1 patient, and satisfied in the others. （4） Postoperative complications： The complications were injury of hypoglossal nerve in 4 patients （25%） and injury of recurrent laryngeal nerve in 1 patient （6%）, and the complications recovered or turned better after conservative treatments for 1 - 3 months. CONCLUSION： Carotid endarterectomy can ameliorate the symptoms and physical signs of patients with cerebral ischemia, and it has mild postoperative complications.
