颈动脉损伤的外科治疗(附16例报告)

目的 探讨颈动脉损伤的早期诊断和外科治疗方法。方法 回顾性分析2003年10月至2006年12月哈尔滨医科大学附属第二医院血管外科收治的16例颈动脉损伤的临床资料。颈外动脉损伤4例，颈总动脉损伤3例，颈内动脉损伤1例，颈动脉假性动脉瘤3例，颈动脉血栓形成1例，医源性颈动脉损伤4例。结果行颈外动脉结扎4例，颈总动脉修补2例，自体大隐静脉移植7例，覆膜支架植入2例，抗凝溶栓1例。死亡1例，偏瘫、失语1例．Homer综合征5例，声音嘶哑、饮水呛咳5例，7例痊愈。结论 早期诊断，及时有效的止血，修复血管．尽快恢寅颈动脉血流和必要的脑保护措施是降低病死率，减少神经系统并发症的关键。

Surgical management of carotid artery injury:a report of 16 cases

Objective To explore the early diagnosis and surgical management method of carotid artery injury. Methods The clinical data of 16 cases of carotid artery injury treated from October 2003 to December 2006 in the Department of Vascular Surgery of Second Affiliated Hospital of Harbin Medical University were analyzed. Among them, external carotid artery injury, common carotid artery injury, internal carotid artery, carotid pseudoaneurysm artery, thrombosis in carotid artery and iatrogenic carotid artery injury was in 4,3,1,3,1 and 4 case respectively. Results Ligation of external carotid artery,repairing of common carotid artery, auto great saphenous vein transplantation, endovascular stent-grafts inplantation, anticoagulation and thrombolysis was performed in 4,2,7,2 and 1 case respectively. Among 16 patients, there were death, hemiplegia-aphasia, Homer syndrome and hoarse voice-hydroposia bucking in 1,1,5 and 4 cases respectively. The rest was recovery. Conclusion Early diagnosis, effective haemostasis and reconstruction of carotid artery are the keys to reduce the mortality and decrease the morbidity of neurological deficit.