CAS与CEA在治疗颈动脉狭窄的疗效比较研究

Comparative study of the efficacy of CAS and CEA in the treatment of carotid stenosis

目的比较CAS与CEA在治疗颈动脉狭窄的疗效比较。方法选择2014年12月~2016年12月在我院就诊的拟行介入治疗及手术治疗的颈动脉狭窄患者100例为研究对象。随机分为CAS组与CEA组,分别采用CAS治疗与CEA治疗。比较两组患者1周内并发症发生率,30天内死亡率、急性脑卒中发生率以及心肌梗死发生,1年内急性心肌梗死发生率。结果术后1周,CAS组并发症发生率显著高于CEA组,差异有统计学意义(P<0.05)。术后30天CAS组急性脑卒中发生率高于CEA组,心肌梗死发生率低于CEA组,两组比较差异有统计学意义(P<0.05)。术后30天,CAS组非致残性脑卒中发生率低于CEA组,差异有统计学意义(P<0.05)。随访1年,CAS组共19例发生心肌梗死,CEA组共9例发生心肌梗死,CAS组显著高于CEA组,差异有统计学意义(P<0.05)。结论 CAS与CEA治疗颈动脉狭窄各有优缺点,在临床工作中,应根据患者具体情况,选择最佳手术方法,并积极预防近远期并发症。

Objective To compare the efficacy of CAS and CEA in the treatment of carotid stenosis. Methods From December 2014 to December 2016, one hundred cases with carotid artery stenosis who scheduled for interventional therapy and surgical therapy were selected as subjects. All cases were randomly divided into CAS group and CEA group, and respectively received CAS or CEA. Incidence of complications within 1 week, mortality, incidence of acute stroke and myocardial infarction within 30 days, and the incidence of acute myocardial infarction in 1 year were compared between two groups. Results One week after operation, incidence of complications in the CAS group was higher than that in the CEA group, which showed significant difference（P〈0.05）. Thirty days after operation, incidence of acute cerebral apoplexy in the CAS group was higher, and incidence of myocardial infarction was lower than those in the CEA group, which showed significant difference（P〈0.05）. Thirty days after operation, incidence of non-deformity stroke in the CAS group was lower than that in the CEA group, which showed significant difference（P〈0.05）. Followed-up for 1 year, 19 cases of myocardial infarction in group CAS, 9 cases in group CEA, the rate of group CAS was higher than that of group CEA, which showed significant difference（P〈0.05）. Conclusion CAS and CEA have advantages and disadvantages in the treatment of carotid artery stenosis. In clinical work, the best operative method should be selected according to the specific conditions of patients, and recent and long-term complications should be actively prevented.