颈动脉内膜剥脱术与颈动脉支架置入术治疗颈动脉狭窄患者的效果比较

Comparison of effects of carotid endarterectomy and carotid artery stenting on patients with carotid artery stenosis

目的:比较颈动脉内膜剥脱术(CEA)与颈动脉支架置入术(CAS)治疗颈动脉狭窄患者的效果。方法:选取2018年9月至2020年9月该院收治的74例颈动脉狭窄患者进行前瞻性研究,按随机数字表法分为对照组和研究组各37例。对照组采用CAS治疗,研究组采用CEA治疗。比较两组临床疗效、手术前后神经功能缺损情况[美国国立卫生研究院卒中量表(NIHSS)]评分和凝血功能指标[活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、凝血酶原时间(PT)]水平,以及并发症发生率。结果:研究组治疗总有效率为94.59%(35/37),高于对照组的75.68%(28/37),差异有统计学意义(P<0.05);术后,两组NIHSS评分均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);术后,两组APTT、TT和PT均长于术前,且研究组长于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为2.70%(1/37),低于对照组的21.62%(8/37),差异有统计学意义(P<0.05)。结论:相较于CAS,CEA治疗颈动脉狭窄患者可提高治疗总有效率,更好地改善神经功能和凝血功能,并降低并发症发生率。

Objective: To compare effects of carotid endarterectomy(CEA) and carotid artery stenting(CAS) on patients with carotid artery stenosis. Methods: Seventy-four patients with carotid artery stenosis admitted to our hospital from September 2018 to September 2020 were selected for prospective study, and were divided into control group and study group according to random number table method, with 37 cases in each group. The control group was treated with CAS, while the study group was treated with CEA. The clinical efficacy, the neurological deficits before and after the surgery [national institutes of health stroke scale(NIHSS)], the coagulation function index levels [activated partial thromboplastin time(APTT), thrombin time(TT), prothrombin time(PT)], and the incidence of complications were compared between the two groups. Results: The total effective rate of treatment in the study group was 94.59%(35/37), which was higher than 75.68%(28/37) in the control group, and the difference was statistically significant(P<0.05). After the surgery, the NIHSS scores of the two groups were lower than those before the surgery, that of the study group was lower than that of the control group, and the differences were statistically significant(P<0.05). After the surgery, the APTT, TT and PT levels in the two groups were all longer than those before the surgery, those of the study group were longer than those of the control group, and the differences were statistically significant(P<0.05). Further, the incidence of complications in the study group was 2.70%(1/37), which was lower than 21.62%(8/37) in the control group, and the difference was statistically significant(P<0.05). Conclusions: Compared with CAS, CEA in the treatment of carotid artery stenosis can improve the total effective rate of treatment, better improve the neurological function and the coagulation function, and reduce the incidence of complications.