颈动脉粥样硬化性狭窄患者应用颈动脉内膜剥脱手术治疗的效果及对患者TESS评分的影响

Effect of carotid endarterectomy on carotid atherosclerotic stenosis and its effect on TESS score in patients

目的探讨颈动脉粥样硬化性狭窄患者应用颈动脉内膜剥脱手术治疗效果及对患者TESS评分影响。方法选取2017年1月~2019年1月我院收治的98例颈动脉粥样硬化性狭窄患者,随机分为两组,各49例。对照组进行颈动脉支架植入术(CAS)治疗,研究组进行颈动脉内膜剥脱手术(CEA)治疗。比较两组患者治疗效果、手术、住院时间、住院费用、围术期及随访不良事件发生率。结果两组总有效率比较,差异无统计学意义(P>0.05);两组患者围术期不良事件发生率比较,差异无统计学意义(P>0.05);研究组住院费用低于对照组(P<0.05),但研究组住院时间和手术时间长于对照组(P<0.05);经随访,两组TESS评分比较,差异无统计学意义(P>0.05),但研究组术后再狭窄发生率低于对照组(P<0.05)。结论颈动脉支架植入术和颈动脉内膜剥脱术具有相似治疗效果,在安全性方面没有明显差异。但颈动脉内膜剥脱术可减少住院费用,降低术后再狭窄发生率,具有较高的临床价值,应进一步推广应用。

Objective To investigate the effect of carotid endarterectomy on carotid atherosclerotic stenosis and its effect on TESS score in patients.Methods A total of 98 patients with carotid atherosclerotic stenosis in our hospital from January 2017 to January 2019 were enrolled.They were randomly divided into two groups,each of 49 cases.The control group was treated with carotid artery stenting(CAS).The study group was treated with carotid endometrial ablation(CEA)treatment.The treatment outcomes,surgery,length of hospital stay,hospitalization costs,and incidence of adverse events during perioperative period and follow-up were compared between the two groups.Results There was no statistically significant difference in the total effective rate between the two groups(P>0.05).There was no significant difference in the incidence of perioperative adverse events between the two groups(P>0.05).The hospitalization cost of the study group was lower than that of the control group(P<0.05).But the hospital stay time and operation time in the observation group were shorter than those of the control group(P<0.05).There was no significant difference in TESS score between the two groups during follow-up(P>0.05),but the incidence of restenosis was lower in the study group than that in the control group(P<0.05).Conclusion Carotid stenting and carotid endarterectomy have similar therapeutic effects,and have no significant difference in safety.However,carotid endarterectomy can reduce the cost of hospitalization,reduce the incidence of restenosis and has a very high clinical value.It should be further popularized and applied.