摘要
目的观察颈动脉内膜剥脱(CEA)及血管补片修补术后患者在重症监护室(ICU)期间围术期的合并症,探索术后有益的管理策略。方法入选我院脑血管中心2008年10月—2009年10月所有CEA及血管补片修补术后转入ICU的患者,收集其一般住院资料、术后在ICU期间的合并症、药物治疗及近期疗效。结果共入选25例患者,平均年龄(67.36±8.70)岁,平均入住ICU时间(4.48±7.18)d,平均住院时间(35.76±23.14)d。术后高血压20例(80%),其中严重高血压〔收缩压≥180mmHg或(和)舒张压≥110mmHg〕7例(28%),术后缺血性脑血管事件2例(8%)(眼动脉栓塞1例,脑梗死1例),高血糖14例(56%),颈部血肿2例(8%)(其中1例行血肿清除术),面部感觉减退2例(8%)。在ICU期间,原发症状完全消失14例(56%),症状缓解9例(36%),无缓解2例(8%),死亡0例,总有效为23例(92%)。结论 CEA术后患者存在严重并发症的风险,总体近期疗效好,术后精细的综合管理必须重视。
Objective To observe the perioperative complication in hospitalized eases in intensive care unit after carotid endoarterectomy （CEA） and vascular patch neoplasty, and to explore the beneficial postoperative administration strategy.Methods Hospitalized cases in our cerebral vessel centre who were performed with CEA and vascular patch neoplasty from October 1, 2008 to October 1, 2009 were selected, and the general data, perioperative complication, drug therapy and therapeutic effect in ICU were recorded. Results 25 cases were included, the average age was （67.36 ±8.70） years old. The average stay in ICU was （4. 48±7. 18） days, the average stay in hospital was （35.76 ±23. 14） days. 20 cases （80%） had postoperative hypertension, among them 7 cases （28%） had critical hypertension （systolic blood pressure ≥ 180 and/or diastolic blood pressure≥110mmHg） , 2 cases （ 8% ） had stroke （ one complicated with ophthalmic artery embolism, the other complicated with cerebral infarction） , 14 cases （56%） had hyperglycaemia, 2 cases （8%） had cervical hematoma （1 case was cured by operation） , 2 cases （8%） had facial hypesthesia. During ICU, 14 cases （56%） were cured, 9 cases （36%） were relieved, 2 eases （ 8% ） were no - relieved, no one was dead. The total effective rate was 92%. Conclusion Some severe complication risk should be complicated in cases with CEA and tissue - engineering vascular patch neoplasty, the recent therapeutic effect was good, and the precise stratgy of perloperative general administration should be emphasized.
出处
《实用心脑肺血管病杂志》
2011年第1期85-87,共3页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
