颅外阻塞性脑血管病的外科治疗

目的探讨颅外阻塞性脑血管病的外科治疗。方法回顾总结 1997～ 2 0 0 2年手术治疗颅外阻塞性脑血管病 34例的经验。其中 2 3例有不同程度的脑缺血症状 ,11例无任何脑缺血症状。病变部位在颈动脉分叉及颈动脉起始处 2 5例 ,其中 2 2例行单纯颈动脉内膜剥脱术 (carotidendarferecfomy ,CEA) ,3例行CEA 补片 ;病变在锁骨下动脉起始处 5例 ,其中 4例行锁骨下动脉锁骨下动脉搭桥 ,1例行锁骨下动脉颈总动脉搭桥术 ;颈总动脉闭塞 4例 ,均行锁骨下动脉颈总动脉搭桥术。结果 32例术后恢复良好 ,1例术后第 4天并发缺血性脑卒中 ,1例因术后第 2天高血压脑出血死亡。结论外科手术是预防和治疗颅外阻塞性脑血管病的有效方法。

SURGICAL TREATMENT OF EXTRACRANIAL CEREBRAL VESSEL DISEASES

ObjectiveStudy on therapeutic effect on endarterectomy in neck region.MethodsThirty-four patients with extracranial cerebral vessel diseases had been treated by various types of endarterectomy from 1997 to 2002,23 cases of whom had some symptoms of cerebral ischemia,11 of whom had no symptom.Among them 25 cases of lesion sites located at bifurcation of common carotid artery or initial part of internal carotid artery and 22 cases of them had been treated by carotid endarferecfomy(CEA),3 cases of them by CEA plus patch.Five cases of lesion sites located at initial part of subclavian artery,4 of whom had been treated by bypass operation between subclavian artery and subclavian artery,and one of whom by bypass operation between subclavian artery and common carotid artery.Four of whom were occluded in common carotid artery had been done bypass operation between subclavian a.and common carotid a.ResultsThirty-two cases had recovered rather well,one case had some complications of cerebral stroke fourth day after operation,one case died of hypertensive cerebral hemorrhage second day after operation.ConclusionSurgical treatment may be an effective therapy for prevention and treatment of extracranial stenosis of cerebral vessels.