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症状性颈动脉狭窄及闭塞82例外科治疗经验
叶波1,夏来阳1*,刘小春1,陈伟清1,赵志青2
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(1.江西省赣州市人民医院、南昌大学附属赣州医院血管外科,赣州 341000
2.第二军医大学长海医院血管外科,上海 200433
*通信作者)
摘要:
目的 回顾性分析应用不同的外科方式干预颈动脉狭窄和闭塞的疗效。方法 对2002年3月至2011年3月收治的82例87侧颈动脉狭窄、闭塞患者,应用颈动脉内膜切除手术治疗76侧,其中传统内膜切除6侧(联合补片成形3侧),外翻式内膜切除70侧,2例同期行双侧颈动脉内切除术; 应用支架成形治疗4侧; 应用相关旁路手术7例。本组病例均为症状性颈动脉重度狭窄、闭塞(70%~100%)。结果 术中、术后无脑卒中、死亡病例; 4例术后皮下血肿,12例术后伸舌偏向患侧,经对症处理后均恢复。结论 个体化分析、选择合适的外科干预方式治疗颈动脉狭窄和闭塞疾病能够取得较好的疗效。
关键词:  颈动脉狭窄  颈动脉内膜切除术  支架  旁路术
DOI:10.3724/SP.J.1008.2012.0204
投稿时间:2011-10-10修订日期:2012-01-04
基金项目:
Surgical treatment of symptomatic carotid artery stenosis and occlusion: experience with 82 cases
YE Bo1,XIA Lai-yang1*,LIU Xiao-chun1,CHEN Wei-qing1,ZHAO Zhi-qing2
(1. Department of Vascular Surgery, People’s Hospital of Ganzhou, Affiliated Ganzhou Hospital of Nanchang University, Ganzhou 341000, Jiangxi, China
2. Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author.)
Abstract:
Objective To retrospectively analyze the effectiveness of different surgical methods in treatment of carotid stenoses and occlusion. Methods From Mar. 2002 to Mar. 2011, a total of 82 patients (87 sides) with carotid stenosis or occlusion received different treatments. Seventy-six of them received endarterectomy, including the traditional cut and sew in 6 sides (3 patching), eversion endarterectomy in 70 sides (including 2 cases receiving double-side endarterectomy). Stenting was performed on 4 sides, and bypass operation was used in 7 cases. All the patients had severe symptomatic carotid artery stenosis and occlusion (70%-100%). Results There was no stroke or death during or after the procedure. Subcutanous hematoma occurred in 4 cases, and 12 cases had the tongue inclining to the lesion side. Conclusion Individualized surgical intervention can achieve satisfactory effect in patients with symptomatic carotid artery stenosis and occlusion.
Key words:  carotid stenosis  carotid endarterectomy  stents  bypass