动脉内膜切除术治疗症状性颈动脉狭窄的临床探讨

Carotid Endarterectomy for Symptomatic Carotid Stenosis (a Report of 23 Cases)

目的探讨颈动脉内膜切除治疗症状性颈动脉狭窄的手术方式及患者的预后,为长段颈动脉狭窄患者的手术治疗提供一个新的思路和方法。方法症状性颈动脉狭窄患者23例中,2例行标准颈动脉内膜切除术;3例行标准颈动脉内膜切除并血管补片成形术;18例行外翻式颈动脉内膜切除术,其中2例术中同时应用环形内膜切除器行颈总动脉内膜切除。结果手术均获成功,术后患者脑缺血症状明显改善,临床效果显著。结论颈动脉内膜切除,特别是应用环形内膜切除器行颈总动脉内膜切除,可以有效地改善缺血性脑血管病患者的脑血流,预防脑卒中的发生。

Objective To explore the operative method and curative effect of carotid endarterectomy （CEA） in the patients with symptomatic carotid stenosis in order to provide a new operative thoughtway and method to treat long-segment carotid stenosis. Methods CEA was performed in 23 patients with symptomatic carotid stenosis, of whom, 2 received standard CEA, 3 standard CEA and angioplasty with patches, 16 eversion CEA, and 2 eversion CEA and endarterectomy of common carotid artery with ring-stripper. Results All the operations were successful. The cerebral ischemic symptoms were significantly ameliorated after the operation in all the patients. Conclusion CEA, special endarterectomy of common carotid artery with ring-stripper can increase brain blood flow and ameliorate the cerebral ischemic symptoms in the patients with symptomatic carotid stenosis.