心脏彩色超声联合颈动脉超声检查在疑似冠心病诊断中的意义

目的探讨心脏彩色超声联合颈动脉超声在冠心病诊断中的价值。方法选取2015年1月至2018年10月在隆昌县人民医院就诊的疑似冠心病167例,最后经冠状动脉造影确诊冠心病患者108例,非冠心病患者59例,均给予心脏彩色超声、颈动脉超声检查。结果冠心病组Tei指数、颈总动脉内膜厚度(intima thickness,IMT)和斑块积分分别为(0.57±0.04)、(1.32±0.21)mm和(2.27±0.87)分,明显高于非冠心病组(t=16.73、19.45、11.68;P <0.05);冠心病三支病变患者Tei指数、IMT及斑块积分分别为(0.62±0.06)、(1.44±0.23)mm和(2.81±0.92)分,明显高于单支病变和双支病变组(F=13.28、20.01、23.20;P <0.05);双支病变患者Tei指数、IMT及斑块积分分别为(0.56±0.05)、(1.30±0.19)mm和(2.18±0.87)分,明显高于单支病变(P <0.05);Tei指数、IMT及斑块积分诊断冠心病的ROC曲线下面积为(0.75、0.81和0.78,P<0.05);联合诊断冠心病的灵敏度、特异度、阳性预测值和阴性预测值分别为94.44%、42.37%、75.00%和80.65%。结论心脏彩色超声联合颈动脉超声在协助冠心病诊断中有较高的应用价值。     

冠心病患者颈动脉粥样硬化与冠状动脉造影的关系

目的评价颈动脉粥样硬化与冠状动脉性心脏病(冠心病)的关系。方法对冠状动脉造影证实的冠心病患者153例(冠心病组)和非冠心病者(正常组)42例进行双侧颈动脉超声检查,测定血管后壁内膜-中膜厚度(inteima-media thickness,IMT),记录斑块数目,并计算斑块积分,同时冠心病组按血管狭窄累及主要病变血管支数分为单支病变亚组(63例)、双支病变亚组(49例)、3支病变亚组(41例)。结果冠心病组斑块发生率[68%(104/153) vs.11.9%(5/42),P<0.05]、颈动脉IMT[(1.11±0.19)mm vs.(0.82±0.06)mm,P<0.05]、斑块积分[(5.03±3.33)分vs.(1.11±0.75)分,P<0.05]和Gensini评分[(21.7±10.3)分vs.(0.0±0.0)分,P<0.05]比正常组高,差异有统计学意义。冠心病3支病变亚组和双支病变亚组斑块发生率、颈动脉IMT、斑块积分和Gensini评分均比单支病变亚组高,差异有统计学意义(P<0.05)。冠心病、原发性高血压、糖尿病、低密度脂蛋白、吸烟、肥胖与颈动脉IMT呈显著正相关(P<0.05)。结...     

老年人外周动脉粥样硬化与冠心病的相关性

目的 探讨老年人外周动脉粥样硬化与冠心病的相关性. 方法 选择拟行冠状动脉造影的老年住院患者152例,年龄62～91岁.于冠状动脉造影前1周内行颈动脉和股动脉超声检查.分别测量颈动脉和股动脉内膜-中膜厚度(IMT)、斑块总面积及颈动脉斑块总积分,并判断颈动脉粥样硬化分型,冠心病病变的程度和范围以冠状动脉病变支数及Gensini积分表示. 结果颈动脉IMT、斑块发生率、斑块总面积及斑块总积分在冠心病单支病变组(16例)分别为(0.93±0.10)mm、61.3%、(0.58±0.11)mm~2及(3.82±2.11)分;双支病变组(41例)分别为(0.92±0.14)mm、72.5%、(1.57±0.37)mm~2及(4.59±3.39)分;3支病变组(72例)分别为(0.95±0.11)mm、87.3%、(1.88±0.15)mm~2及(6.67±5.90)分;非冠心病组(23例)分别为(0.81±0.13)mm、42.7%、(0.28±0.69)mm~2及(1.83±1.65)分.股动脉IMT、斑块发生率及斑块总面积在冠心病单支病变组分别为(0.97±0.11)mm、38.3%及(0.24±0.26)mm~2;双支病变组分别为(1.07±0.15)mm、57.9%及(0.51±0.21)mm~2;3支病变组分别为(1.15±0.14)mm、59.5%及(0.59±0.23)mm~2;非冠心病组分别为(0.90±0.13)mm、26.8%及(0.20±0.17)mm~2.冠心病各组上述各项指标高于非冠心病组(均P<0.05),其中双支病变组和3支病变组颈动脉斑块总面积、股动脉斑块总面积及股动脉IMT高于单支病变组(均P<0.05),3支病变组颈动脉斑块总积分高于单支病变组和双支病变组(均P<0.05).相关分析结果表明.颈动脉粥样硬化分型、斑块总积分及面积与冠脉病变支数间呈正相关(r分别为0.282、0.307及0.494,均P<0.01);颈动脉粥样硬化斑块面积与Gensini积分呈正相关(r=0.472,P<0.01).股动脉IMT、斑块总面积与冠脉病变支数呈正相关(r分别为0.415及0.692,均P<0.01),与Gensini积分亦呈正相关(r分别为0.404、0.648,均P<0.01).颈动脉斑块总面积(OR=2.2;95%CI 0.79～2.46)、股动脉斑块总面积(OR=1.6;95%CI 0.28～1.35)及股动脉IMT(OR=1.6;95% CI 1.20～15.10)是冠状动脉Gensini积分的独立预测因子. 结论 超声检查结果评价老年人外周动脉粥样硬化与冠心病的严重程度相关.     

经颈动脉彩色超声对冠心病早期的临床预测价值

目的 探讨颈动脉硬化指标与冠状动脉性心脏病的关系.方法 选取山西医科大学第一医院心内科住院的拟诊冠心病并行冠状动脉造影患者160例,根据冠脉造影结果分为冠心病组(90例)和非冠心病组(70例).分别对受试对象行颈动脉彩色超声,观察内膜-中层厚度(IMT)及粥样硬化斑块(AP)形成情况.结果 冠心病组IMT较对照组明显增厚(1.08 mm±0.18 mm比0.76 mm±0.13 mm,P＜0.05),AP发生率也明显增高(60%对11%,P＜0.05).结论 颈动脉IMT厚度及AP形成可作为早期预测冠状动脉病变情况的指标.     

超声在老年冠心病患者颈动脉硬化及血流动力学检测中的价值

目的探讨超声在老年冠心病患者颈动脉硬化及血流动力学检测中的价值。方法选取老年冠心病患者103例为实验组,根据冠状动脉造影结果将实验组分为单支病变组53例和非单支病变组50例,另选同期进行体检的无冠心病的老年患者103例为常规组。所有患者均接受超声检测,分析并比较颈动脉硬化情况和血流动力学参数。结果实验组内中膜厚度(IMT)增厚比例、存在斑块比例、IMT厚度、斑块厚度、Crouse积分均显著高于常规组,软斑比例显著高于常规组,扁平斑、硬斑比例显著低于常规组(均P<0.05),两组混合斑比例无统计学差异(P>0.05);实验组收缩期峰值流速(PSV)、阻力指数(RI)显著高于常规组(P<0.05);单支病变组IMT增厚比例、颈动脉斑块比例均显著低于非单支病变组(P<0.05)。结论应用超声可准确检测老年冠心病颈动脉硬化程度和血流动力学参数,为冠心病诊断和治疗提供有效依据。     

颈动脉粥样斑块超声指标与冠状动脉粥样硬化的相关性分析

目的分析超声检测颈动脉内-中膜厚度(IMT)对诊断冠状动脉粥样硬化病变的价值,及冠状动脉粥样硬化Gensini评分与颈动脉粥样硬化Crouse积分的相关性,为冠状动脉粥样硬化性心脏病(冠心病)的防治提供简单易行的检测依据。方法选取成都医学院附属第二医院及四川大学华西医院于2015年1月~2017年1月心血管内科诊治并行冠状动脉造影(CAG)检查的患者114例,根据CAG检查结果将其分为非冠心病组(n=40)与冠心病组(n=74),再根据冠状动脉病变支数将冠心病组分为三个亚组,比较非冠心病组、冠心病组的颈动脉IMT、颈动脉斑块Crouse积分,探讨Gensini评分与Crouse积分的关系;评估颈动脉超声诊断冠心病临床价值。结果冠心病组的IMT较非冠心病组显著增厚,差异具有统计学意义(P0.05),其三个亚组(单支病变亚组、两支病变亚组、三支病变亚组)的IMT分别为(0.94±0.15)mm、(1.17±0.17)mm、(1.21±0.23)mm;非冠心病组Crouse积分为(1.11±0.75)分,Gensini积分为(0.0±0.0)分;冠心病组Crouse积分为(5.14±3.41)分,Gensini积分为(22.2±11.02)分,冠心病组上述指标均高于非冠心病组(P0.05);相关性分析显示Crouse积分与Gensini积分呈正相关(r=0.354,P=0.001);诊断实验四格表显示颈动脉超声诊断冠心病的诊断符合率为86.0%。结论利用颈动脉超声检查的指标去诊断冠状动脉粥样硬化病变严重程度与颈动脉粥样硬化程度的相关性,具有可实践性,值得临床推广。     

颈动脉粥样硬化对冠心病的预测价值

目的：研究超声检测颈动脉粥样硬化对冠心病的预测价值。方法：应用彩色多普勒超声仪观察230例冠心病患者与41例非冠心病患者颈动脉内膜-中膜厚度（IMT）、斑块形成情况和斑块积分。结果：颈动脉IMT与斑块发生率和斑块积分在冠心病组明显高于对照组（P〈0．05）。结论：超声检查颈动脉硬化可在一定程度上反映冠状动脉粥样硬化情况,可帮助评估预后。     

颈动脉内中膜厚度及斑块与冠心病的关系

目的 通过对颈动脉内中膜厚度(intima-media thickness, IMT)及斑块检出,探讨颈动脉硬化与冠心病(CHD)的相关性.方法 应用彩色多普勒超声成像仪对149例疑似冠心病者测定IMT及对斑块分级,并通过冠状动脉造影(CAG)检查分为冠心病组99例和非冠心病组50例,比较两组间颈动脉IMT、斑块指数及颈动脉斑块检出率.结果 冠心病组颈动脉IMT(t=2.578)、斑块指数(t=3.182)显著高于非冠心病组(P＜0.01);冠心病组颈动脉粥样硬化斑块检出率较非冠心病组明显增高.结论 颈动脉粥样硬化斑块与冠心病密切相关,是及早预测冠心病的一个较好指标.     

颈动脉粥样斑块及内中膜厚度与冠心病的关系

目的:探讨颈动脉内中膜厚度(IMT)以及粥样斑块发生率情况与冠心病的关系.方法:采用冠状动脉造影术筛选冠心病及非冠心病组,对114例经选择性冠状动脉造影检查的患者行颈动脉超声检查,测量IMT以及观察粥样斑块发生率情况.结果:对照组及冠心病组IMT为0.67±0.10 mm及 0.85±0.26 mm,斑块发生率为10%(4/40)及63.5%(47/74),组间相比均具有显著性差异,P<0.001,以IMT≥0.85mm及/或出现粥样斑块来预测冠心病,特异性85%,敏感性71.6%,阳性预测率89.8%.结论:颈动脉与冠状动脉粥样硬化间存在着密切关系,通过颈动脉超声检查可预诊冠心病的存在.     

颈动脉内中膜厚度与脑梗死的相关性研究

目的 探讨颈动脉内中膜厚度(IMT)以及粥样硬化斑块的发生情况与脑梗死的相关性.方法 采用彩色多普勒超声仪对102例脑梗死患者及98例非脑血管病患者行颈动脉超声检查,测量IMT以及观察粥样硬化斑块的发生情况,并作对比分析.结果 脑梗死组IMT,左侧为1.39 mm±0.13 mm,右侧为1.27 mm±0.14 mm;非脑血管病组IMT,左侧为0.79 mm±0.18 mm,右侧为0.62 mm±0.05 mm.脑梗死组左右两侧颈动脉IMT明显高于非脑血管病组(P<0.01).脑梗死组颈动脉粥样硬化斑块发生率为71.8%(73/102),其中软斑检出率63.1%,硬斑检出率为21.7%,混合斑检出率为15.2%;非脑血管病组颈动脉粥样硬化斑块发生率为35.7%(35/98),其中软斑检出率34.3%,硬斑检出率为65.7%,未检出混合斑.组间比较,脑梗死组斑块发生率、软斑检出率及混合斑栓出率均高于非脑血管病组,而硬斑检出率则低于非脑血管病组(P<0.01).结论 颈动脉IMT以及粥样硬化斑块,尤其是不稳定斑块的发生与脑梗死密切相关,是脑梗死不可忽视的危险因素.     

颈动脉转流管在颈动脉内膜切除术中的临床应用

目的探讨颈动脉转流管在颈动脉内膜切除术（CEA）中的应用价值。 方法收集胜利油田中心医院神经外科&头颈血管外科2013年1月至2019年8月935例行CEA患者的临床资料,纳入统计标本的有304例症状性颈动脉重度狭窄合并颅内血流代偿较差的患者。术中行转流管转流的患者为转流管组（98例）,术中未行转流管转流的患者为对照组（206例）,通过比较2组患者术后症状改善率、术后并发症发生率及血管再狭窄发生率,对术中转流管的应用进行全面系统的研究。 结果转流管组和对照组的术中颈动脉阻断时间分别为（2.3±0.6）min和（13.6±8.2）min,术后出现颅脑过度灌注发生率分别为1.02%（1/98）和7.28%（15/206）,2组对比差异均有统计学意义（P<0.05）;2组患者术后症状改善率、术后其他并发症发生率及血管再狭窄发生率比较差异无统计学意义（P>0.05）。 结论对于症状性颈动脉重度狭窄合并颅内血管代偿较差的患者,CEA中转流管的熟练应用是安全可靠的。     

Safety of carotid artery stenting for symptomatic carotid artery disease: a meta-analysis.

AIMS: Clinical trials comparing carotid artery stenting (CAS) with carotid endarterectomy (CEA) for patients with symptomatic carotid artery disease have produced conflicting results. We performed a meta-analysis to systematically evaluate currently available data by comparing CAS with CEA in patients with symptomatic carotid artery disease. METHODS AND RESULTS: We searched MEDLINE, Embase, ISI Web of Knowledge, Current Contents, International Pharmaceutical Abstracts databases, the Cochrane Central Register of Controlled Trials, and scientific meeting abstracts up to 31 October 2006 and then calculated summary risk ratios (RRs) for mortality, stroke, disabling stroke, and death using random- and fixed-effect models. Data from five trials with 2122 patients were pooled. There was no difference in risk of 30-day mortality (summary RR 0.57, 95% CI 0.22-1.47, P = 0.25), stroke (summary RR 1.64, 95% CI 0.67-4.00, P = 0.34), disabling stroke (summary RR 1.67, 95% CI 0.50-5.62, P = 0.50), death and stroke (summary RR 1.54, 95% CI 0.81-2.92, P = 0.19), or death and disabling stroke (summary RR 1.19, 95% CI 0.57-2.51, P = 0.64) among patients randomized to CAS, compared with CEA. CONCLUSIONS: No significant differences could be identified between CAS and CEA in the treatment of patients with symptomatic carotid artery disease. Larger randomized controlled trials are warranted to compare the two strategies.     

Increased subclinical atherosclerosis in patients with chronic plaque psoriasis

Background: Psoriasis is an immune-mediated inflammatory skin condition of unknown aetiology which usually requires life-long treatment. It is regarded a systemic inflammatory disease with a possible increased risk of cardiovascular disease. The aim of this study was to assess carotid intima-media thickness (IMT), plaque prevalence and carotid stenosis as surrogate measures for cardiovascular disease in psoriasis patients and healthy controls. Methods: Sixty-two patients with psoriasis and thirty-one healthy controls were included in the study. All were examined by Colour duplex ultrasound of the carotid arteries to compare carotid IMT values, carotid plaques and carotid stenosis in the two groups. Adjustments were made for traditional cardiovascular risk factors. Results: Patients with psoriasis had increased carotid IMT values compared to the controls: mean ± SD 0.71 ± 0.17 mm vs. 0.59 ± 0.08 mm; p = 0.001. When adjusted for known atherosclerotic risk factors this difference remained significant (p = 0.04). Carotid plaques were also more common (p = 0.03) in patients with psoriasis 13 (21%) compared to controls 1 (3%). There was no difference with regard to the number of carotid stenoses in patients and controls. Conclusion: The results of this study support previous evidence which suggests that psoriasis is associated with an increased risk for atherosclerosis and subsequent cardiovascular disease.     

颈动脉血管成形术和颈动脉内膜切除术治疗颈动脉狭窄近期疗效的Meta分析

目的评价颈动脉血管成形术和颈动脉内膜切除术治疗颈动脉狭窄的近期临床疗效和安全性。方法电子检索中国学术期刊网全文数据库(1996—2006年)、MEDLINE(1996—2006年)和Cochrane图书馆(2006年12月前已发表的文献和已注册但未发表的临床试验),并与研究者取得联系获得更多的相关研究资料。纳入比较颈动脉血管成形术和内膜切除术治疗颈动脉狭窄的随机对照试验,比较两种治疗方法术后30d内卒中发生率和卒中与死亡的联合发生率。以卒中发生率作为疗效评价指标,以卒中和死亡的联合发生率作为安全性评价指标。2名评价员独立检索和提取资料,对纳入试验的方法学质量进行评价,数据采用RevMan4.2.10版软件进行统计分析。结果在术后30d内的卒中发生率方面,共纳入7项临床试验的2747例患者,其中颈动脉血管成形术组1381例,颈动脉内膜切除术组1366例。在术后30d的卒中和死亡的联合发生率方面,纳入8项临床试验,共2966例患者,其中颈动脉血管成形术组1488例,颈动脉内膜切除术组1478例。Meta分析结果显示,在术后30d内的卒中发生率方面,颈动脉血管成形术略高于颈动脉内膜切除术(OR:1.44;95%CI:1.05~1.97,Z=2.28,P=0.02);在术后30d内卒中和死亡的联合发生率方面,颈动脉血管成形术与颈动脉内膜切除术间差异无统计学意义(OR:1.50;95%CI:0.89~2.52,Z=1.51,P=0.13)。结论现有临床研究资料显示,在目前的技术条件下,颈动脉血管成形术在治疗颈动脉狭窄的近期疗效方面未显示优于内膜切除术;而在治疗的安全性方面,两者间差异无统计学意义。     

颈动脉内膜切除术治疗颈动脉极重度狭窄或闭塞患者可行性和安全性的评价

目的探讨对颈动脉极重度狭窄（狭窄率为95％～99％）或闭塞患者行颈动脉内膜切除术（CEA）的可行性和安全性。方法回顾性分析首都医科大学宣武医院神经外科2001年1月-2012年12月入院的65例症状性颈动脉极重度狭窄或闭塞患者的临床资料。术前行CT灌注（CTP）或氙CT评价大脑半球的血流灌注情况及经DSA评估病变血管,根据具体病变分别行单纯CEA、CEA＋Fogarty球囊取栓、CEA＋颈动脉支架置入的复合手术。结果①65例患者均接受DSA评估颈动脉病变,其中颈动脉完全闭塞32例,极重度狭窄33例;采用氙CT评价脑血流15例,其中脑血流量（CBF）部分区域下降6例（40．0％）,患侧脑血管反应性（CVR）明显降低11例（73．3％）;采用CTP评价32例,CBF部分区域下降11例（34．4％）,达峰时间延长32例（100％）。②对65例患者行CEA＋Fogarty球囊导管取栓术10例,9例再通;行复合手术4例,一例再通失败;51例单纯行CEA,5例未能再通。本组患者再通率为89．2％。③术后30d内共5例患者出现卒中,3例为出血性卒中,1例死亡;另2例为缺血性卒中。术后卒中和病死率为7．7％。结论对症状性颈动脉极重度狭窄或闭塞患者,经过严格的适应证选择,术前对颈动脉和大脑半球的血流灌注进行充分的影像学评估后,可行血管再通手术。短期随访显示,CEA及其复合手术治疗具有较好的可行性和安全性．     

Fate of the external carotid artery following carotid interventions

OBJECTIVE:

The external carotid artery (ECA) is an important collateral pathway for cerebral blood flow. Carotid artery stenting (CAS) typically crosses the ECA, while carotid endarterectomy (CEA) includes deliberate ECA plaque removal. The purpose of the present study was to compare the long-term patency of the ECA following CAS and CEA as determined by carotid duplex ultrasound.

METHODS:

Duplex ultrasounds and hospital records were reviewed for consecutive patients undergoing CAS between February 2002 and April 2008, and were compared with those undergoing CEA in the same time period. Preoperative and postoperative ECA peak systolic velocities were normalized to the common carotid artery (CCA) as ECA/CCA ratios. A significant (80% or greater) ECA stenosis was defined as an ECA/CCA ratio of 4.0. A change of ratio by more than 1 was defined as significant. Data were analyzed using Student’s t test and χ² analysis.

RESULTS:

A total of 86 CAS procedures in 83 patients were performed (81 men, mean age 69.9 years). Among them, 38.4% of patients had previous CEA, 9.6% of whom had contralateral internal carotid artery occlusion. Sixty-seven CAS and 65 CEA patients with complete duplex data in the same time period were included in the analyses. There was no difference in the incidence of severe ECA stenosis on preoperative ultrasound evaluations. During a mean follow-up of 34 months (range four to 78 months), three postprocedure ECA occlusions were found in the CAS group. The likelihood of severe stenosis or occlusion following CAS was 28.3%, compared with 11% following CEA (P<0.025). However, 62% of CEA patients and 57% of CAS patients had no significant change in ECA status. Reduction in the patient’s degree of ECA stenosis was observed in 9.4% of CAS versus 26.6% of CEA patients. Overall, immediate postoperative ratios of both groups were slightly improved, but there was a trend of more disease progression in the CAS group during follow-up.

CONCLUSION:

CAS is associated with a higher incidence of post-procedure ECA stenosis. Despite the absence of neurological symptoms, a trend toward late disease progression of ECA following CAS warrants long-term evaluation.     

颈动脉内膜切除术治疗颈动脉次全或完全闭塞的术后再通超声评估

目的应用血管超声对颈动脉次全或完全闭塞病变行颈动脉内膜切除术(CEA)后再通患者的近、远期效果进行评估。方法回顾性连续纳入2005年1月—2014年1月在首都医科大学宣武医院经DSA确诊为颈动脉闭塞性病变,并接受CEA治疗的患者共107例,其中次全闭塞(颈动脉狭窄率95%~99%)63例,完全闭塞44例。记录所有患者围手术期并发症的发生情况。随访采用门诊随访、电话跟踪的方式,超声随访手术再通患者术后1周及3、6、12、24个月的情况,记录CEA术后患者临床预后、血管再狭窄、血管结构及血流动力学的改变。结果 (1)107例患者手术后再通86例(80.4%),未通21例(19.6%)。术后30d内卒中及死亡发生率为4.7%(5例),其中次全闭塞组发生率为4.8%(3例),完全闭塞组为4.5%(2例)。(2)术后1周内再通患者的患侧大脑中动脉收缩期峰值血流速度(PSV)、舒张期末血流速度(EDV)及血管搏动指数均较术前明显升高[分别为(120±39)cm/s比(60±17)cm/s,(50±18)cm/s比(33±11)cm/s和0.96±0.20比0.67±0.14]差异有统计学意义(均P0.01);颈动脉超声显示再通患者原病变局部血管内径均较术前增宽[分别为(4.4±1.1)和(3.6±1.0)mm)],差异有统计学意义(P0.01)。(3)超声随访颈动脉再通患者69例,时间为1~60个月,中位数为12个月。术后1~6个月血管通畅比率95.6%(66例),6~12个月血管通畅比率94.2%(65例),12~24个月血管通畅比率94.2%(65例),2年以上血管通畅比率91.3%(63例)。结论血管超声可对颈动脉闭塞性病变CEA后血管再通患者进行近期及远期的跟踪随访,判断血流改善程度,及时发现术后再狭窄。     

Prevalence and One-year Outcome of Carotid Sinus Hypersensitivity in Unexplained Syncope: A Prospective Cohort Study from South India

Background

Carotid sinus syndrome accounts for one third of patients who presents with unexplained syncope. Prevalence of carotid sinus hypersensitivity (CSH) in Indians has not been studied till now.

颈动脉内膜剥脱术对缺血性脑卒中的防治效果分析

目的总结颈动脉内膜剥脱术对防治缺血性脑卒中的经验。方法对196例患者进行颈动脉内膜剥脱术,均为单侧。术中应用颈动脉转流管47例,阻断血流149例。术前均经颈动脉造影检查,选择颈内动脉狭窄〉70％者133例,〉95％者63例。71例患者并存冠状动脉病变,17例同台行冠状动脉搭桥。结果术后临床症状改善满意191例,术后1周内出现脑出血3例,经开颅止血引流,痊愈1例,死亡2例。出现颈部切口内血肿12例,再手术清创止血获愈。随访6～60个月,获得随访166例,失访28例,死于其他疾病或灾祸38例,元脑缺血症状再发作128例。结论颈动脉内膜剥脱术是治疗颈动脉重度狭窄的一种有效、安全术式。