颈动脉内膜剥脱术围手术期的处理

目的 探讨颈动脉内膜剥脱术的适应证及围手术期处理。方法 回顾性总结9例因短暂性脑缺血伴有颈动脉硬化狭窄患者而行颈动脉内膜剥脱术的临床资料。结果 所有患者的短暂性脑缺血表现消失，部分患者慢性脑缺血症状也得到明显的改善。术后未出现偏瘫或脑出血等严重的并发症。结论 短暂性脑缺血病人经Doppler超声或数字减影动脉造影术或核磁血管成像检查发现一侧或双侧颈总动脉或颈内动脉狭窄大于50％者，可以考虑行颈动脉内膜剥脱术。对于双侧颈动脉狭窄者，分期手术治疗较为安全。作好围手术期处理，有助于减少手术并发症发生。

Perioperative Managements of Carotid Endoarterectomy

Objective To study the indications of carotid endoarterectomy (CEA) and perioperative managements. Methods Clinical data of 9 patients with transient ischemia attack (TIA) and carotid artery stenosis who underwent CEA were reviewed retrospectively. Results TIA symptoms in all patients disappeared and chronic symptoms of cerebral ischemia also got obvious improvement in part of cases. There were not serious postoperative complications such as cerebral hemorrhage, hemiplegia etc. Conclusion CEA may be considered when one or both sides of carotid stenosis more than 50 percent is discovered by Duplex scanning, digital subtraction angiography (DSA) or MRA in patients with TIA. Stage operation for bilateral carotid occlusive lesion is comparative safe. Paying attention to perioperative managements is important to reduce(operative) complications.