颈动脉内膜切除术对症状性颈动脉狭窄的改善作用研究

Clinical study on the effect of carotid endarterectomy on improvement of symptomatic carotid stenosis

关键词:  颈动脉内膜切除术  症状性颈动脉狭窄  收缩期峰值流速

Key words:  carotid endarterctomy  symptomatic carotid stenosis  peak systolic flow rate of carotid artery

摘要:

目的　研究颈动脉内膜切除术（carotid endarterctomy,CEA)对症状性颈动脉狭窄的改善作用。方法　选取大连市中心医院2015年7月至2017年11月收治的30例症状性颈动脉重度狭窄患者，进行颈部血管超声筛查，记录术前颈动脉收缩期峰值流速，行头颈部血管造影（CTA、MRA或DSA）检查证实 30例患者均为重度狭窄，狭窄率均＞70%。行颈动脉内膜切除术。术后1个月随访，再次行颈动脉超声及头颈部血管造影检查，比较术前与术后的狭窄率及颈动脉收缩期峰值流速。结果　所有入组患者手术均成功实施，术后1个月无再狭窄，均未出现一过性脑缺血发作。术后狭窄率与收缩期峰值流速与术前相比［(6.2±1.0)% vs. (80.0±0.5)%,(91.3±12.0) cm/s vs. (207.0±15.6) cm/s］，差异具有统计学意义，P<0.05。结论　颈动脉内膜切除术对症状性颈动脉狭窄患者具有明显改善作用。

Abstract:

Objective　 To study the improvement effect of carotid endarterctomy (CEA) on symptomatic carotid stenosis. 　Methods　30 patients with severe symptomatic carotid artery stenosis were admitted to dalian central hospital from July 2015 to November 2017.Cervical ultrasonography was performed, the preoperative peak systolic flow rate of carotid artery was recorded, and head and neck angiography (CTA, MRA or DSA) was performed to confirm that all 30 patients were severely stenosis, and the stenosis rate was greater than 70%. All the 30 patients were confirmed as severe stenosis, and the stenosis rate was greater than 70%. After 1 month of follow-up, carotid ultrasound and cephalic angiography were performed again to compare the stenosis rate before and after operation and the peak systolic velocity of carotid artery. 　Results　All the patients were successfully operated, with no restenosis at 1 month after surgery, and no transient ischemic attack. The difference between stenosis rate and systolic peak velocity before and after operation was significant, P<0.05.　Conclusion　Carotid endarterectomy has significant improvement effect on symptomatic carotid stenosis.