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。

Effect of carotid endarterectomy in the prevention and treatment of ischemic strokcure

Objective To summarize the experience of carotid endarterectomy in prevention and treatment of the ischemic stroke. Methods From October 2001 to December 2011, 196 patients with unilateral internal carotid artery stenosis received carotid endarterectomy. In operation, carotid artery, shunts were applied in 47 cases, bloc- king blood flow in 149 eases. The preoperative carotid angiography showed internal carotid artery stenosis greater than 70% in 133 cases, more than 95% in 63 cases. There were 71 cases to be complicated by coronary artery lesions, 17 cases received coronary artery bypass simultaneously. Results The postoperative clinical symptoms improved in 191 cases, cerebral hemorrhage appeared in 3 eases within 1 week after operation, among them after the hemostatie erani- otomy drainage, 1 case was healed, 2 cases died. In 12 cases hematoma appealed inside cervical incision and were cured by the surgical debridement hemostasis. All cases were foUowed up for 6 to 60 months, 166 cases received fol- low-up, lost fellow-up in 28 cases, 38 cases died of disaster or ill in a follow-up. There were no attack of cerebral is- chemic symptoms again in128 cases. Conclusion Carotid endartereetomy is an effective and safe treatment for severe carotid artery stenosis.