Chang Jee Won, Kim Su Wan, Lee Seogjae, Lee Jonggeun, Ku Min Jung
Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine.
Korean J Thorac Cardiovasc Surg. 2017 Apr;50(2):94-98. doi: 10.5090/kjtcs.2017.50.2.94. Epub 2017 Apr 5.
Intraoperative monitoring during carotid endarterectomy is crucial for cerebral protection. We investigated the results of carotid endarterectomy under dual monitoring with stump pressure and electroencephalography.
We retrospectively reviewed the medical records of 50 patients who underwent carotid endarterectomy between March 2010 and February 2016. We inserted a temporary shunt if the stump pressure was lower than 35 mm Hg or if any intraoperative change was observed on electroencephalography.
Seventeen (34%) patients used a temporary shunt, and the mean stump pressure was 26.8 mm Hg in the shunt group and 46.5 mm Hg in the non-shunt group. No postoperative mortality or bleeding occurred. Postoperatively, there were 3 cases (6%) of minor stroke, all of which took place in the shunt group. A comparison of the preoperative and the intraoperative characteristics of the shunt group with those of the non-shunt group revealed no statistically significant difference between the 2 groups (p <0.01).
Dual monitoring with stump pressure and electroencephalography was found to be a safe and reliable monitoring method with results comparable to those obtained using single monitoring. Further study should be performed to investigate the precise role of each monitoring method.
颈动脉内膜切除术期间的术中监测对于脑保护至关重要。我们研究了在残端压力和脑电图双重监测下颈动脉内膜切除术的结果。
我们回顾性分析了2010年3月至2016年2月期间接受颈动脉内膜切除术的50例患者的病历。如果残端压力低于35mmHg或脑电图出现任何术中变化，我们就插入临时分流管。
17例（34%）患者使用了临时分流管，分流组的平均残端压力为26.8mmHg，非分流组为46.5mmHg。术后无死亡或出血发生。术后有3例（6%）发生轻微中风，均发生在分流组。分流组与非分流组术前和术中特征的比较显示两组之间无统计学显著差异（p<0.01）。
发现残端压力和脑电图双重监测是一种安全可靠的监测方法，其结果与单监测相当。应进行进一步研究以探讨每种监测方法的确切作用。
