彩色多普勒超声对行颈动脉内膜剥脱术患者围术期评估的价值分析

目的 探讨彩色多普勒超声对行颈动脉内膜剥脱术患者的应用价值。 方法 选取金华市中心医院2015年2月-2017年3月收治的53例行颈动脉内膜剥脱术患者作为研究对象,分别于行颈动脉内膜剥脱术前、术中、术后对其进行彩色多普勒超声检查,记录患者病变位置,狭窄程度,狭窄处血管内径,血流动力学参数及术后近期预后情况。 结果 53例患者共检测动脉狭窄84处,其中单侧病变20例,双侧病变33例。彩色多普勒超声检测和数字减影血管造影(DSA)检测的狭窄程度一致性效果很好(Kappa=0.857,P<0.001);术中颈动脉吻合后,22例患者经彩色多普勒超声检测共发现33处细条带状高回声,其中31处为轻度异常,均为<3 mm的游离内膜片,另外2处为显著异常,均为细带状血栓;术后患者狭窄处血管内径及血流动力学参数均较术前明显改善(均P<0.01);术后3个月内,患者死亡率为0%,3例术后出现颈部血肿,1例手术部位出现增生、水肿,1例发生缺血性脑梗死(术中彩色多普勒超声显示多处<2 mm的游离内膜片)。 结论 彩色多普勒超声在颈动脉内膜剥脱术术前诊断、术中评估及术后预后判断均具有重要的临床应用价值。 

The clinical value of color ultrasound in perioperative patients with carotid endarterectomy

Objective To investigate the clinical value of color ultrasound in perioperativepatients with carotid endarterectomy. Methods A total of 53 breast cancer patients were selected in our hospital from February, 2015 to March, 2017. All of patients treated with carotid endarterectomy. To observe lesion location, degree of coronary artery stenosis, narrow blood vessels, hemodynamic index changes and postoperative prognosis during perioperative stage. Results There were 84 cases of arterial stenosis in 53 patients, including 20 patients with unilateral lesions and 32 patients with bilateral lesions. Consistency was good between color ultrasound detection and DSA detection (Kappa=0.857, P<0.001); After suture of carotid artery, 33 thin strips of high echo were detected by color doppler ultrasonography in 22 patients, including 31 for mild abnormalities which were < 3 mm free internal diaphragm, and the other two is significantly abnormal which were Zonal thrombus; The endovascular diameter and hemodynamic indexes were significantly improved after operation (all P<0.01); Within 3 months after operation, the mortality rate of the patients was 0, 3 patients with cervical hematoma, 1 patient with hyperplasia and edema of surgical site, 1 case with ischemic cerebral infarction whose color ultrasound showed the various free internal diaphragm of < 2 mm. Conclusion Color ultrasound has important clinical application value on preoperative diagnosis, intraoperative evaluation and postoperative prognosis in patients with carotid endarterectomy.