中国实用外科杂志2012年8月第32卷第8期
红枣糯米糕
论著文章编号：1005-2208（2012）08-0659-03
动脉内膜剥脱术治疗颈动脉狭窄179例临床分析乔彤，刘长建，黄佃，刘晨，冉峰，王炜，张明，周敏
【摘要】目的分析颈动脉内膜剥脱术后并发症的原因，探讨其防治措施。方法回顾性分析南京大学医学院附属鼓楼医院血管外科收治的因严重颈动脉狭窄行颈动脉内膜剥脱术179例。其中标准式颈动脉内膜剥脱术（SCEA）87例，外翻式颈动脉内膜剥脱术（ECEA）92例。转流管使用35例，均为SCEA术式。结果所有手术操作顺利。围手术期内发生急性颈动脉血栓形成1例、脑梗死2例、脑出血2例、暂时性失读1例、舌下神经损伤1例、声音嘶哑1例、伤口血肿3例。围手术期死亡1例。结论手术指征不严、术中操作失误、术后处理不当是导致相关并发症的主要因素。对于并发症的发生重在预防，发生后必须准确判断、处理迅速。
【关键词】颈动脉狭窄；颈动脉内膜剥脱术
中图分类号：R6文献标志码：A
Prevention and management of postoperative complications of carotid endarterectomy QIAO Tong,LIU Chang-jian,HUANG Dian,et al.Department of Vascular Surgery,Drum Tower Hospital,Affiliated Hospital
of Medical College,Nanjing University,Nanjing210008,China
Corresponding author:QIAO Tong,E-mail:
儿童睡眠Abstract Objective To study the reasons of complications after carotid endarterectomy(CEA),and discuss the prevention and management.Methods The data of179cas of vere carotid artery stenosis(CAS)treated by CEA at Drum Tower Hospital,Affiliated Hospital of Medical College,Nanjing University were analyzed retrospectively.All the cas included87cas of standard carotid endoarterectomy(SCEA)and92cas of eversion carotid endoarterectomy (ECEA).The shunts were ud in35cas,which were all treated by SCEA.Results All procedures were successful. The postoperative complications included aute ICA thrombosis in1ca,cerebral infarction in2cas,cerebral hemorrhage in2cas,temporary alexia in1ca,hypoglossal nerve injury in1ca,superior laryngeal nerve injury in1 ca and wound hematoma in3cas.One ca of death resulted from cerebral hemorrhage in perioperative period.
Conclusion The complications of CEA result from incorrect operation indication,operative procedure and postoperative management.The prevention of complication is very important.The complications must be diagnod exactly and treated as soon as possible.
天麻乌鸡汤Keywords carotid artery stenosis；carotid endarterectomy
颅外颈动脉硬化狭窄（carotid artery stenosis，CAS）为导致脑梗死的常见原因，符合适应证的CAS病人行颈动脉内膜剥脱术（carotid endoarterectomy CEA）能显著降低脑梗死的发生率［1］，而相关术后并发症的预防和处理亦日益得到重视。本文对南京大学医学院附属鼓楼医院血管外科收治的179例CEA临床资料进行回顾性分析总结。报告如下。
1临床资料
1.1一般资料本组179例、184侧CAS行CEA。其中男106例，女73例。接受双侧CEA者5例。年龄平均6
2.5岁。既往有高血压161例、高血脂127例、糖尿病63例、冠心病51例。有症状的164例中，129例有明确脑梗死病史，2例处于偏瘫恢复期；35例有典型反复短暂性脑缺血发作（TIA）病史，包括一过性黑朦、眩晕、肢体轻瘫和短暂失语等。有脑梗死病史者，病史2年以上38例，1～2年者41例，2个月至1年者47例。2个月以内者3例，最短为2d。无明确症状者13例为B超发现颈动脉狭窄87%～99％，2例为颈部听诊闻及明显动脉收缩期杂音进一步检查确诊。
怎么破手机密码1.2术前检查及手术适应证所有病例均行B超检查，其中147例行增强CT扫描（CTA）检查，139例接受数字减影
琵琶读音基金项目：江苏省科教兴卫工程专项经费资助项目［苏卫科教（2011）15号］
作者单位：南京大学医学院附属鼓楼医院血管外科，江苏南京210008丰富海
通讯作者：乔彤，E-mail：
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