摘要
目的探讨颈动脉转流技术在冠状动脉旁路移植术(CABG)同期颈动脉内膜切除术(CEA)中的作用。方法回顾性分析中国医科大学附属第一医院2017年3月至2019年7月,CABG同期CEA治疗伴发无症状颈动脉重度狭窄的需要CABG手术治疗的不稳定性心绞痛患者资料。标准式CEA术中使用颈动脉转流技术,记录CEA术中颈动脉阻断时间,围手术期及术后随访期间卒中、脑过度灌注综合征(CHS)、死亡及颈动脉术后再狭窄。结果共收集10例CEA同期CABG的临床资料。CEA术中平均颈动脉阻断时间5 min,平均随访时间10个月,未出现卒中、CHS、死亡和颈动脉再狭窄。结论CABG同期CEA术中使用颈动脉转流技术,治疗伴发无症状颈动脉重度狭窄的需要CABG患者可以获得围手术期和长期良好疗效。
Objective The optimal operative strategy in patients with asymptomatic severe carotid artery stenosis undergoing coronary artery bypass grafting(CABG)is unknown.We sought to investigate the safety of carotid arterial shunting during simultaneous CABG and carotid endarterectomy(CEA).Methods The clinical data of patients undergoing synchronous combined CEA and CABG in the First Hospital of China Medical University between March 2017 and July 2019 was retrospectively studied.Patients with asymptomatic severe carotid artery stenosis≥70%according to NASCET(North American Symptomatic Carotid Endarterectomy Trial)were required CABG surgery.During conventional CEA,carotid arterial shunting was used in all cases.Results Ten patients were recruited.The average clamping time of carotid artery was 5 minutes.The average follow-up time was 10 months.We did not observe stroke,cerebral hyper perfusion syndrome,death and carotid restenosis.Conclusions Carotid arterial shunting during synchronous combined CEA and CABG was helpful for obtaining good curative effect.
作者
佟志勇
谷天祥
刘源
王刚
师恩祎
王春
毛乃惠
姜大庆
喻磊
王鸿亮
Tong Zhiyong;Gu Tianxiang;Liu Yuan;Wang Gang;Shi Enyi;Wang Chun;Mao Naihui;Jiang Daqing;Yu Lei;Wang Hongliang(Department of Neurosurgery,the First Hospital of China Medical University,Shenyang 110001,China;Department of Cardiac Surgery,the First Hospital of China Medical University,Shenyang 110001,China;Shenyang Institute of Computing Technology,Chinese Academy of Sciences,Shenyang 110168,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2019年第39期3085-3088,共4页
National Medical Journal of China
基金
2019年沈阳市科技计划项目人口与健康专项(19-112-4-062)
辽宁省重点研发计划(2018225096)。
