多模态监测下颈动脉内膜剥脱术治疗颈内动脉重度狭窄

doi:10.3877/cma.j.issn.2095-123X.2022.03.009

中华脑科疾病与康复杂志(电子版) ›› 2022, Vol. 12 ›› Issue (03) : 167 -170. doi: 10.3877/cma.j.issn.2095-123X.2022.03.009

短篇论著

多模态监测下颈动脉内膜剥脱术治疗颈内动脉重度狭窄

易竟¹, 姚陵¹^,^†(

), 文江力¹, 阙思伟¹

^1. 415003　湖南常德，常德市第一人民医院神经外科

收稿日期:2022-01-03 出版日期:2022-06-15
通信作者: 姚陵
基金资助:
湖南省临床医疗技术创新引导项目(2018SK50201); 常德市科技局项目(2020S028)

Carotid endarterectomy under multimodal monitoring for severe internal carotid artery stenosis

Jing Yi¹, Ling Yao¹^,^†(), Jiangli Wen¹, Siwei Que¹

^1. Department of Neurosurgery, The First People’s Hospital of Changde City, Changde 415003 China

Received:2022-01-03 Published:2022-06-15
Corresponding author: Ling Yao

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目的

探讨多模态监测下颈动脉内膜剥脱术治疗颈内动脉重度狭窄的临床疗效。

方法

回顾性分析常德市第一人民医院神经外科自2018年1月至2021年9月实施颈动脉内膜斑块剥脱术治疗的15例颈内动脉重度狭窄患者的基本资料、术后并发症和复查情况。

结果

1例患者在预阻断时，多普勒提示血流下降50%，但电生理未提示异常，提高血压，未予以术中转流；3例患者电生理及多普勒同时提示低灌注，予以术中转流后均好转。术后所有患者无明显并发症，术后复查未见再狭窄。

结论

多模态监测下颈动脉内膜剥脱术治疗颈内动脉重度狭窄安全有效。

关键词: 颈内动脉狭窄, 多模态监测, 颈动脉内膜剥脱术

Objective

To investigate the clinical efficacy of carotid endarterectomy under multimodal monitoring in the treatment of severe internal carotid artery stenosis.

Methods

The basic data, postoperative complications and postoperative reexamination of 15 patients with severe internal carotid artery stenosis treated by carotid intimal plaque stripping in the Neurosurgery Department of The First People’s Hospital of Changde City from January 2018 to September 2021 were analyzed retrospectively.

Results

In one patient during pre-blocking, Doppler showed that the blood flow decreased by 50%, but the electrophysiology did not indicate abnormality, increased blood pressure and did not convert to blood flow. Electrophysiology and Doppler showed hypoperfusion in 3 patients, which improved after intraoperative conversion. All patients had no obvious complications after operation, and there was no restenosis after operation.

Conclusion

Carotid endarterectomy under multimodal monitoring is safe and effective in the treatment of severe internal carotid artery stenosis.

Key words: Internal carotid artery stenosis, Multimodal monitoring, Carotid endarterectomy

图1 颈内动脉重度狭窄患者手术资料 A：术前头颈部CTA；B：术中切口；C：暴露颈内动脉；D：术后头颈部CTA

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Carotid endarterectomy under multimodal monitoring for severe internal carotid artery stenosis