颈动脉内膜切除术相关并发症及处理

目的分析颈动脉内膜切除术(carotid endarterectomy,CEA)后并发症的原因并探讨其处理原则。方法回顾性总结1992年2月至2002年3月280例颈动脉内膜切除术(其中治疗陈旧性脑中风242例,预防性颈动脉内膜切除术38例)的临床资料。结果术后合并高血压59例(21·1%)、低血压30例(10·7%)、脑灌注损害16例(5·7%)、皮下血肿5例(1·8%)、脑卒中5例(1·8%)、颈动脉血栓4例(1·4%)、颅神经损害1例(0·4%)。术后随访:5年内血管再狭窄73例(26·1%)。结论根据残端指数选择性应用临时性转流,术中严格控制血压可减少术后并发症的发生。

Postoperative complications of carotid endarterectomy and its management

Objective To analyze the causes and m an agement of postoperative complications of carotid endarterectomy(CEA). Methods Between Feb 1992 and Mar 2002, a total of 280 cases underwent carotid endarterectomy, including elective surgery in 242 cases and prophylactive procedure in 38 cases. Results Postoperative hypertension developed in 59 cases(21.1%),hypotension in 30 cases(10.7%),cranium reperfusion injury in 16 cases (5.7%), subcutaneous haematoma in 5 cases (1.8%),stroke in 5 case s (1.8%), acute internal carotid thrombosis in 4 cases (1.4%),and cranium neur ological deficits in 1 case (0.4%). Recurrent stenosis developed in 73 cases ( 26.1%) during a follow-up period of 5 years.Conclu sion Use of temporal shunt selectively according to t he internal carotid stump index, controlling blood pressure strictly help to red uce the occurrence of postoperative complications.