颈动脉狭窄：基于重复双功能超声检查的治疗方案改变。
Carotid stenosis: change of treatment plan based on repeat duplex ultrasonography.
机构信息
Department of Surgery, The University of Kansas School of Medicine - Wichita, KS 67214, USA.
出版信息
Am J Surg. 2012 Feb;203(2):121-6. doi: 10.1016/j.amjsurg.2010.11.016. Epub 2011 Jul 23.
BACKGROUND
This study was conducted to evaluate the change in the treatment plan observed when clinical decisions are made based on initial carotid duplex ultrasonography (DU) performed at an outside center before surgical consultation versus those made based on DU performed in a dedicated vascular laboratory.
METHODS
A prospective study of patients who underwent initial DU at an outside facility and repeat DU in a dedicated vascular laboratory for evaluation of carotid stenosis was performed. Initial DU was compared with repeat DU to evaluate clinical impact.
RESULTS
Ninety-six consecutive patients were evaluated. Disagreement between initial DU and repeat DU was observed in 27.1% of patients. This disagreement led to a change of treatment plan in 23 of 146 (15.8%) carotid arteries studied.
CONCLUSIONS
Reliance on 1 DU in clinical practice, when performed outside a dedicated vascular laboratory, may lead to both unnecessary surgery and missed opportunities for surgery to prevent stroke.
背景
本研究旨在评估在外科咨询前于外院进行的初始颈动脉双功能超声（DU）检查基础上制定的临床决策与在专门的血管实验室进行的 DU 检查基础上制定的临床决策之间观察到的治疗方案变化。
方法
对在外部机构进行初始 DU 检查并在专门的血管实验室进行重复 DU 检查以评估颈动脉狭窄的患者进行前瞻性研究。比较初始 DU 与重复 DU 以评估临床影响。
结果
评估了 96 例连续患者。27.1%的患者出现初始 DU 与重复 DU 不一致。这种不一致导致在 146 条研究颈动脉中有 23 条（15.8%）改变了治疗方案。
结论
在临床实践中，当在专门的血管实验室之外进行时，对 1 次 DU 的依赖可能导致不必要的手术和漏诊预防中风的手术机会。
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