动脉内膜切除治疗颈动脉狭窄

目的 探讨脉内膜切除的手术指征、麻醉和手术方法。方法 ２０例病人２２例颈动脉狭窄，其中２１例在全麻下手术，１侧采用局麻。２０例术中颈动脉阻断时间２７￣５２分钟，２侧术中采用分流。１５侧手术在脑电图监测下进行。结果 １７例病人１８侧术后顺利；另３例４侧手术，其中３侧椁后分别出现暂时性肌力减退和下部面瘫。１９例病人平均随访３年２个月，９例暂时性脑缺血病人中，８例停止发作，１例发作减少，９例脑梗死病人，

Endarterectomy for carotid stenosis

Objective To discuss the indications, anesthesia and surgical techniques of carotid endarterectomy (CEA). Methods Twenty-two sides of carotid stenosis were revealed in 20 patients. CEA was performed under general anesthesia in 21 sides and local anesthesia in one. The time of carotid occlusion ranged from 27 to 52 minutes (averag 35 .5 min) in 20 operations, and intraoperative shunt was used in the other two.Fifteen operations were monitored with EEG. Results The postoperative course was uneventful in 17 patients after 18 operations, while transient muscle strength decrease on contralateral side and ipsilateral lower facial paresis occurred after three operations in the other three patients. Nineteen patients were followed-up for 38 months on the average. Among nine patients with TLA, ischemic attacks ceased in eight and decreased in one. Improvement was achieved in six patients with cerebral infarction. One patient without symptoms of carotid ischemia was still normal after operation. Conclusion Carotid endarterectomy is a safe and effective way for treating carotid stenosis.