使用术前经颅多普勒变量预测哪些患者在颈动脉内膜切除术中不需要分流。
The use of preoperative transcranial Doppler variables to predict which patients do not need a shunt during carotid endarterectomy.
作者信息
Visser G H, Wieneke G H, van Huffelen A C, Eikelboom B C
机构信息
Department of Clinical Neurophysiology, University Hospital Rotterdam, The Netherlands.
出版信息
Eur J Vasc Endovasc Surg. 2000 Mar;19(3):226-32. doi: 10.1053/ejvs.1999.1009.
OBJECTIVES
to analyse whether preoperative transcranial Doppler (TCD) variables can predict intraoperative shunt requirement.
DESIGN AND METHODS
the blood-flow velocity (BFV) in the major basal cerebral arteries was measured preoperatively with TCD, in 178 patients scheduled for CEA. Carotid artery compression and CO2 reactivity tests were also performed. Intraoperative electroencephalography was used to decide whether a shunt was needed. Differences in the probability of shunt requirement between the categories of variables were assessed with crosstabs statistics.
RESULTS
preoperative TCD criteria clearly identified a subgroup of 59 patients (33%) who did not require a shunt. In general, these patients appeared to have adequate collateral flow through the anterior communicating artery. In contrast, prediction of the need for a shunt was less reliable. TCD variables could predict the need for a shunt with a probability of only 60%.
CONCLUSIONS
preoperative TCD can be used to identify patients who do not require a shunt during carotid endarterectomy.
目的
分析术前经颅多普勒（TCD）变量是否能够预测术中分流需求。
设计与方法
对178例计划接受颈动脉内膜切除术（CEA）的患者，术前采用TCD测量大脑主要基底动脉的血流速度（BFV）。还进行了颈动脉压迫试验和二氧化碳反应性试验。术中采用脑电图来决定是否需要分流。采用交叉表统计评估不同变量类别之间分流需求概率的差异。
结果
术前TCD标准明确识别出59例（33%）不需要分流的患者亚组。总体而言，这些患者似乎通过前交通动脉有足够的侧支血流。相比之下，对分流需求的预测可靠性较低。TCD变量预测分流需求的概率仅为60%。
结论
术前TCD可用于识别在颈动脉内膜切除术中不需要分流的患者。
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