颈动脉内膜切除术后高灌注综合征的诊断与治疗

目的探讨颈动脉内膜切除术后高灌注综合征的机制、临床表现和治疗方法。方法回顾性分析3例颈动脉内膜切除术后高灌注综合征患者的临床资料，特别是术中和术后的血压管理、经颅多普勒超声（TCD）监测脑血流速度和最终的治疗及转归。结果2例患者经严格控制血压1～3d后，脑血流速度恢复正常，脑高灌注状态得以缓解。1例患者因血压控制不佳，导致脑高灌注状态，诱发脑出血而死亡。结论颈动脉内膜切除术后高灌注综合征有潜在的危险，经严格控制血压后，多于术后1～3d缓解。

Hyperperfusion syndrome after carotid endarterectomy

Objective To investigate the causes, clinical features and treatment of hyperperfusion syndrome after carotid endarterectomy Methods 3 cases with hyperperfusion syndrome after carotid endarterectomy were assessed retrospectively. Their blood pressure, cerebral blood flow velocities during and after operation, as well as results of treatment were studied. Results 2 cases recovered after 1-3 days with controlled blood pressure. Hyperperfusion syndrome after carotid endartereetomy resolved by controlling blood pressure under normal level for 1 - 3 days in 2 cases. The other case died of cerebral hemorrhage due to uncontrolled hypertension. Conclusion Hyperperfusion syndrome is identified as dangerous situation after carotid endarterectomy which may be overcomed by controlling blood pressure strictly for 1 - 3 days.