感染性颈动脉破裂的治疗

目的　探讨感染性颈动脉破裂的治疗方法。方法 回顾性分析我科自2000～2011年所有感染性颈动脉破裂病例及同期内所有英语文献记载的病例。结果 31例患者共发生46次感染性颈动脉破裂，最常见的破裂部位为颈总动脉（33/46，71.7%）。经血管结扎治疗17次（37.8%），血管内支架置入20次（44.4%）, 栓塞治疗7次（15.6%）。血管结扎在治疗感染性颈动脉破裂时再次出血发生率11.8%（2/17）明显低于血管内支架置入60.0%（12/20）差异有统计学意义（χ 2=4.355， P =0.037）。结论 血管结扎是感染性颈动脉破裂较好的治疗方法，它可能是防止再次出血的最好方法。但是如果结扎颈内动脉或颈总动脉，其并发症发生率可能相对较高。

Management of infected carotid artery rupture

OBJECTIVE To explore the treatment of infected carotid artery rupture（CAR）.METHODS We reviewed all patients with infected carotid artery rupture at our department from 2000 to 2011 and performed a retrospective review of the medical records combined with an English language literature review of the same period.RESULTS A total of 46 episodes of infected CAR occurred in the 31 patients.The most common site of bleeding was the common carotid artery（33/46,71.7%）.Seventeen episodes（17/45,37.8%） were treated with surgical ligation,20（44.4%） with stent placement,and 7（15.6%） with embolization.Surgical ligation had a lower rate of recurrent bleeding（2/17,11.8%） than stent placement（12/20,60.0%） when used for the treatment of infected CAR（χ2=4.355,P =0.037）.CONCLUSION Surgical ligation is an effective option in the management of infected CAR and may be the best choice to prevent recurrent hemorrhage.The complication rate is high when the common carotid or the internal carotid arteries are ligated.