本文選題：頸動脈內(nèi)膜剝脫術(shù) + 手術(shù)時機��； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：探討頸動脈內(nèi)膜剝脫術(shù)(carotid endarterectomy, CEA)治療頸動脈狹窄上幾個有爭議的方面的規(guī)范性問題。方法：收集新疆醫(yī)科大學(xué)第四附屬醫(yī)院進(jìn)行的CEA手術(shù)63例的臨床資料,進(jìn)行回顧性分析。分別以手術(shù)時機、麻醉方式、放置轉(zhuǎn)流、放置補片,這幾個研究因素分成4個研究組。分別檢驗組間觀察指標(biāo)(主要為術(shù)后并發(fā)癥,遠(yuǎn)期通暢率)是否有統(tǒng)計學(xué)差異。主要的觀察指標(biāo)與臨床因素間使用Logistic回歸分析,觀察臨床因素的危險度。結(jié)果：1、以表格形式描述各臨床因素的初步統(tǒng)計結(jié)果和術(shù)后結(jié)果。2、分組研究。不同手術(shù)時機進(jìn)行CEA手術(shù)的術(shù)后觀察指標(biāo)上無明顯差異(P0.05)。早期手術(shù)并不比推遲手術(shù)風(fēng)險高。不同麻醉方式下進(jìn)行CEA手術(shù)的術(shù)后觀察指標(biāo)上無明顯差異(P0.05)。兩種麻醉方式都是安全的。是否放置轉(zhuǎn)流進(jìn)行CEA手術(shù)顯示阻斷時間、術(shù)后高灌注綜合征存在顯著差異(P0.05)。放置轉(zhuǎn)流更加安全。是否放置補片在術(shù)后出現(xiàn)再狹窄上存在顯著差異(P0.05)。放置補片減少術(shù)后再狹窄的發(fā)生。Logistic回歸分析顯示患側(cè)狹窄度和術(shù)后血壓波動是CEA術(shù)后腦卒中的危險因素(P0.05)；未放置轉(zhuǎn)流、患側(cè)狹窄度和術(shù)后血壓波動是術(shù)后高灌注綜合征的危險因素(P0.05)；未放置補片是遠(yuǎn)期再狹窄的危險因素(P0.05)。結(jié)論：CEA手術(shù)時機的把握上要嚴(yán)格評估病人病情,兩種麻醉方式都是安全的,術(shù)中放置轉(zhuǎn)流提高手術(shù)安全性,補片成形減少遠(yuǎn)期再狹窄。CEA手術(shù)治療頸動脈狹窄尚待規(guī)范。
[Abstract]:Objective: to investigate several controversial normative issues in carotid artery stenosis treated by carotid endarterectomy (CEA). Methods: the clinical data of 63 cases of CEA operation in the fourth affiliated Hospital of Xinjiang Medical University were retrospectively analyzed. These factors were divided into four study groups according to the time of operation, anaesthesia, transposition and patch placement. There were statistical differences in the observation indexes (mainly postoperative complications, long-term patency rate) between the two groups. The risk of clinical factors was observed by Logistic regression analysis. Results: 1. The preliminary statistical results and postoperative results of all clinical factors were described in tabular form. There was no significant difference in the postoperative indexes of CEA operation at different time of operation (P 0.05). Early surgery is no higher risk than delaying surgery. There was no significant difference in the postoperative indexes of CEA operation under different anesthetic methods (P 0.05). Both methods of anesthesia are safe. There was a significant difference in postoperative hyperperfusion syndrome (HPS) between two groups (P 0.05). Placement of diversion is safer. There was significant difference in restenosis after operation with or without patch placement (P 0.05). Logistic regression analysis showed that the degree of stenosis and the fluctuation of blood pressure were the risk factors of stroke after CEA. The degree of stenosis of the affected side and the fluctuation of blood pressure after operation were the risk factors of postoperative hyperperfusion syndrome (P 0.05), while no patch placement was the risk factor of long term restenosis. Conclusion both anesthesia methods are safe to evaluate the patient's condition strictly in order to grasp the opportunity of the operation. The safety of operation should be improved by placement of bypass during operation and the reduction of long term restenosis by patch forming should be regulated in the treatment of carotid artery stenosis.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R743.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 ;各類腦血管疾病診斷要點[J];中華神經(jīng)科雜志;1996年06期

，

本文編號：1816153