Thompson Sarah K, McKinnon J Gregory, Ghali William A
Department of Surgery, University of Calgary, Calgary, Alta.
Can J Surg. 2003 Oct;46(5):332-4.
Stroke represents a major cause of disability among middle-aged and elderly people. Carotid artery stenosis is an important risk factor for stroke and is prevalent in elderly men with hypertension, diabetes mellitus, and those who smoke or have atherosclerotic disease, or both. Patients who undergo neck dissection for head and neck cancer may have some or all of the above characteristics and may experience surgical manipulation of the carotid arteries. This combination of medical and surgical factors may predispose such patients to perioperative stroke. A critical review of the literature was completed to determine the incidence of stroke perioperatively in patients undergoing a neck dissection for head and neck cancer. We found 2 studies that quoted the risk of stroke to be between 3.2% and 4.8%. The implications of these results are significant because they suggest a need for preoperative screening (with Doppler ultrasonography) or intervention (with carotid endarterectomy), or both. However, the quality of these 2 studies is such that future research is first needed to define the rate of stroke in head and neck surgery.
中风是中老年人残疾的主要原因。颈动脉狭窄是中风的一个重要危险因素，在患有高血压、糖尿病、吸烟或患有动脉粥样硬化疾病或两者兼有的老年男性中普遍存在。接受头颈癌颈部清扫术的患者可能具有上述部分或全部特征，并且可能会经历颈动脉的手术操作。这些医学和手术因素的综合作用可能使此类患者易发生围手术期中风。为了确定接受头颈癌颈部清扫术的患者围手术期中风的发生率，我们完成了对文献的严格审查。我们发现有2项研究指出中风风险在3.2%至4.8%之间。这些结果的意义重大，因为它们表明需要进行术前筛查（使用多普勒超声）或干预（进行颈动脉内膜切除术），或两者都需要。然而，这2项研究的质量使得首先需要未来的研究来确定头颈外科手术中的中风发生率。
