摘要
目的：评估颅外段颈内动脉重度狭窄患者颈动脉内膜切除术预防和治疗缺血性卒中的临床价值。方法：22例患者均由经颅多普勒(TCD)筛选、数字减影血管造影(DSA)或CT血管造影(CTA)检查证实为颈内动脉重度狭窄，其中21例为有症状颈动脉狭窄。22例患者住院期间接受24侧次颈动脉内膜切除术，术后随访并行TCD检查。结果：21例(23侧次)手术过程顺利，随访2～30个月，未再发TIA或脑梗死，19例症状减轻或缓解。1例术后死于脑栓塞和肺部感染。随访期复查TCD1～2次，20例未发现明显再狭窄。结论：颈动脉内膜切除术对治疗重度颈内动脉狭窄，预防TIA和缺血性卒中有效。TCD可作为对重度颈内动脉狭窄的筛选、术中监测和术后随访的重要手段。
Objective: To evaluate the value of carotid endarterectomy (CEA) in patients with severe extracranial internal carotid artery stenosis in the prevention and treatment of ischemic stroke. Methods: Twenty-two patients were screened with transcranial Doppler (TCD), digital substraction angiography (DSA) or computed tomography angiography (CTA) and they were confirmed as severe internal carotid stenosis. Twenty-one of them were symptomatic carotid stenoses. Twenty-four CEAs were performed in 22 patients during the hospitalization. They were followed up and re-examined with TCD. Results:CEAs in 21 patients (23 sides) were successful. No TIA or cerebral infarction recurred during 2 to 30 months' follow up. The neurological deficits improved in 19 patients. One died from cerebral embolism and pulmonary infection after CEA. During the follow up, the patients were re-examined once or twice with TCD, and there was no clear restenosis was found in 20 of them. Conclusion: CEA is effective in the treatment of severe internal carotid stenosis, and is effective in the prevention of TIA and ischemic stroke. TCD is an important tool in screening patients with severe internal carotid stenosis, monitoring blood flow during operations and follow up after the operations.
出处
《国外医学（脑血管疾病分册）》
2004年第2期119-121,共3页
Foreign Medical Sciences Cerebrovascular Diseases
关键词
颈动脉内膜切除术
预防
治疗
缺血性卒中
疗效分析
carotid endarterectomy ischemic stroke internal carotid stenosis transcra-nial Doppler
