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[重复颈动脉缺血性卒中预防的手术及治疗方法的疗效]

[Efficacy of surgical and therapeutic methods of repeated carotid ischemic stroke prophylaxis].

作者信息

Akhmetov V V, Lemenev V A, Alekseeva G S, Stakhovskaia L V, Skvortsova V I

出版信息

Khirurgiia (Mosk). 2006(12):20-3.

Abstract

Comparative efficacy of surgical and therapeutic methods of repeated ischemic stroke prophylaxis at the patients with clinical symptoms of acute brain ischemia and carotid stenosis less 70% was analyzed. Three-year period of follow-up demonstrated that at the patients who have undergone carotid endarterectomy the repeated ischemic events were seen only at 4 (3.9%), and in the group of therapeutic prophylaxis--at 57 (52.7%). Carotid endarterectomy permits to reduce relative risk of repeated ischemic stroke from 0.77 in therapeutic prophylaxis to 0.07 in surgical treatment. Antiaggregant therapy after surgery is mandatory. Prolonged administration of Clopidogrel permits to reduce restenosis and thrombotic complication rate.

摘要

分析了针对急性脑缺血临床症状且颈动脉狭窄小于70%的患者,重复缺血性中风预防的手术和治疗方法的比较疗效。三年的随访期表明,接受颈动脉内膜切除术的患者中,仅4例(3.9%)出现了重复缺血事件,而在治疗性预防组中,有57例(52.7%)出现。颈动脉内膜切除术能够将重复缺血性中风的相对风险从治疗性预防的0.77降低至手术治疗的0.07。术后抗血小板治疗是必需的。长期服用氯吡格雷可降低再狭窄和血栓形成并发症的发生率。

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