颈动脉内膜剥脱术治疗颈动脉硬化狭窄的回顾性分析

Retrospective analysis of carotid endarterectomy for carotid arteriosclerosis stenosis

目的:评价颈动脉内膜剥脱术(CEA)治疗颅外颈动脉硬化狭窄(CAS)的临床效果及并发症。方法:回顾性分析2016年1月~2019年4月弋矶山医院血管外科收治的7例行CEA的中重度颈动脉狭窄患者的临床资料。术中均未使用颈动脉转流管,其中行经典CEA的患者5例,外翻CEA的患者2例。结果:有1例患者术后出现伤口血肿,经切口引流,伤口加压治疗后痊愈。无感染、脑梗死及死亡病例。术前有头昏头痛、短暂性脑缺血发作的患者术后相关的临床症状均有明显改善,甚至完全消失。结论:CAS通过行CEA临床效果良好,虽手术存在严重的如脑梗死等并发症发生的可能性,但可通过手术细节的精准控制做到手术风险可控,是治疗颅外CAS的有效手段。

Objective: To evaluate the clinical efficacy and complications of carotid endarterectomy(CEA) in the treatment of carotid arteriosclerosis stenosis (CAS). Methods :Clinical data were reviewed in 7 cases of moderate and severe carotid artery stenosis admitted to and treated in vascular surgery department of the Affiliated Yijishan Hospital of Wannan Medical College between January 2016 and April 2019.Carotid bypass was free in surgery.Of the 7 patients,5 received classic CEA,and 2 underwent eversion CEA. Results :Postoperative wound hematoma occurred in one patient,and was managed by incision drainage and wound compression.No infection,cerebral infarction or death occurred.The clinical symptoms,including dizziness,headache and transient ischemic attack were significantly improved or totally disappeared. Conclusion :CEA may be effective for CAS,although potential serious complications such as cerebral infarction may occur in surgery,yet the risk can be controlled by careful and precise operation.