颈动脉转流管在颈动脉内膜切除术中的临床应用

Clinical application of carotid shunt in carotid endarterectomy

目的 探讨颈动脉转流管在颈动脉内膜切除术(CEA)中的应用价值。 方法 收集胜利油田中心医院神经外科&头颈血管外科2013年1月至2019年8月935例行CEA患者的临床资料,纳入统计标本的有304例症状性颈动脉重度狭窄合并颅内血流代偿较差的患者。术中行转流管转流的患者为转流管组(98例),术中未行转流管转流的患者为对照组(206例),通过比较2组患者术后症状改善率、术后并发症发生率及血管再狭窄发生率,对术中转流管的应用进行全面系统的研究。 结果 转流管组和对照组的术中颈动脉阻断时间分别为(2.3±0.6) min和(13.6±8.2) min,术后出现颅脑过度灌注发生率分别为1.02%(1/98)和7.28%(15/206),2组对比差异均有统计学意义(P<0.05);2组患者术后症状改善率、术后其他并发症发生率及血管再狭窄发生率比较差异无统计学意义(P>0.05)。 结论 对于症状性颈动脉重度狭窄合并颅内血管代偿较差的患者,CEA中转流管的熟练应用是安全可靠的。

Objective To explore the application value of carotid shunt in carotid endarterectomy(CEA).Methods Collect clinical data of 935 CEA patients in Shengli Oilfield Central Hospital from January 2013 to August 2019,there were 304 patients with severe symptomatic carotid stenosis with poor compensation for intracranial blood flow.Among them,the patients who underwent transflow were the transflow group(98 cases),the patients who did not perform the transflow during the operation were the control group(206 cases).By comparing the rates of symptom improvement,postoperative complications and vascular restenosis in the two groups,the application of intraoperative transfer tube is studied systematically.Results The time of carotid artery occlusion was(2.3±0.6)min and(13.6±8.2)min in the transflow group and the control group,respectively.The incidence of postoperative cerebral hyperperfusion was 1.02%(1/98)and 7.28%(15/206),respectively.The differences between the two groups were statistically significant(P<0.05).However,there was no significant difference in the improvement rate of postoperative symptoms,the incidence of other postoperative complications and the incidence of vascular restenosis between the two groups(P>0.05).Conclusion For the patients with symptomatic severe carotid stenosis and poor intracranial vascular compensation,the skilled application of CEA shunt tube is a safe and reliable technology and worthy of promotion.