發(fā)布時(shí)間：2018-06-28 02:24

  本文選題：動(dòng)脈假性閉塞 + 頸動(dòng)脈內(nèi)膜切除術(shù)��； 參考：《復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版)》2017年04期

【摘要】：目的評(píng)價(jià)頸內(nèi)動(dòng)脈假性閉塞(atheromatous pseudo-occlusion,APO)手術(shù)治療的安全性及有效性。方法對(duì)復(fù)旦大學(xué)附屬中山醫(yī)院2011年12月至2016年6月間接受頸動(dòng)脈內(nèi)膜切除術(shù)的頸動(dòng)脈狹窄患者資料進(jìn)行回顧性分析,其中研究組為APO患者32例,對(duì)照組為重度狹窄(70%~99%)患者124例。對(duì)兩組圍手術(shù)期各主要及次要并發(fā)癥、隨訪中的同側(cè)缺血性腦卒中復(fù)發(fā)率、再狹窄率及死亡率進(jìn)行比較。結(jié)果圍手術(shù)期主要并發(fā)癥:APO組發(fā)生心梗1例(3.1%),無(wú)缺血性腦卒中、腦出血及死亡病例;對(duì)照組發(fā)生缺血性腦卒中2例(1.4%),心肌梗死6例(4.2%),死亡1例(0.7%)。次要并發(fā)癥:APO組發(fā)生切口滲血1例(3.1%),肺部感染2例(6.3%),高灌注綜合征2例(6.3%);對(duì)照組發(fā)生切口滲血3例(2.1%),切口感染2例(1.4%),肺部感染4例(2.8%),顱神經(jīng)損傷2例(1.4%),高灌注綜合征2例(1.4%)。術(shù)后隨訪6~60個(gè)月,平均隨訪(35.3±17.5)個(gè)月。APO組1例(3.1%)同側(cè)缺血性腦卒中復(fù)發(fā),4例(12.5%)發(fā)生再狹窄,死亡3例(9.4%),死因均非神經(jīng)系統(tǒng)疾病。對(duì)照組同側(cè)缺血性腦卒中復(fù)發(fā)8例(5.6%),再狹窄9例(6.3%),死亡8例(5.6%)。兩組間圍手術(shù)期各主要及次要并發(fā)癥,隨訪中的同側(cè)缺血性腦卒中復(fù)發(fā)率、再狹窄率、死亡率的差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論對(duì)APO患者行頸動(dòng)脈內(nèi)膜切除術(shù)治療安全有效,圍手術(shù)期及隨訪結(jié)果滿意。
[Abstract]:Objective to evaluate the safety and efficacy of atheromatous pseudo-occlusion (APO) in the treatment of internal carotid artery pseudoocclusion. Methods the data of 32 patients with carotid artery stenosis who received indirect carotid endarterectomy from December 2011 to June 2016 in Zhongshan Hospital affiliated to Fudan University were retrospectively analyzed. The study group consisted of 32 APO patients and the control group 124 patients with severe stenosis (70%). The primary and secondary complications, recurrence rate, restenosis rate and mortality rate of ipsilateral ischemic stroke were compared between the two groups during perioperative period. Results Myocardial infarction occurred in 1 case (3.1%) in the perioperative group, no ischemic stroke, cerebral hemorrhage and death occurred in the control group, and ischemic stroke occurred in 2 cases (1.4%), myocardial infarction in 6 cases (4.2%) and death in 1 case (0.7%) in the control group. In the control group, incision bleeding occurred in 1 case (3.1%), pulmonary infection in 2 cases (6.3%), hyperperfusion syndrome in 2 cases (6.3%), incision bleeding in 3 cases (2.1%), wound infection in 2 cases (1.4%), pulmonary infection in 4 cases (2.8%), cranial nerve injury in 2 cases (1.4%), hyperperfusion syndrome in 2 cases (1.4%). The average follow-up period was (35.3 鹵17.5) months. One case (3.1%) in APO group had restenosis in ipsilateral ischemic stroke (12.5%) and 3 cases (9.4%) died of non-neurological diseases. In the control group, 8 cases (5.6%) had ipsilateral ischemic stroke recurrence, 9 cases (6.3%) had restenosis, 8 cases (5.6%) died. There was no significant difference in the recurrence rate restenosis rate and mortality rate of ipsilateral ischemic stroke between the two groups during perioperative period. Conclusion carotid endarterectomy is safe and effective in APO patients, and the perioperative and follow-up results are satisfactory.
【作者單位】： 復(fù)旦大學(xué)附屬中山醫(yī)院血管外科-復(fù)旦大學(xué)血管外科研究所;
【基金】：國(guó)家自然科學(xué)基金(81570433) 上海市科委基金(14411962300)~~
【分類號(hào)】：R654.3

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