Wang Mingxin, Li Guoqiang, Sui Shouguang, Cao Shaoyan, Gai Xinyu, Zhu Jingtong, Chao Li Chao Li
Brain Hospital, Shengli Oilfield Central Hospital, Dongying, Shandong Province, China.
Pak J Pharm Sci. 2019 Jan;32(1(Special)):453-457.
The paper discuss the surgical techniques and clinical curative effects of CEA (Carotid Endarterectomy, CEA) under a microscope via anterior cervical triangle posterior vena jugularisinterna approach combining with suspended carotid artery on the treatment of high level and complex carotid artery stenosis. Retrospective analysis was conducted on the clinical data of 21 cases of patients. The far end of carotid artery stenosis section is located above the lower edge of the second cervical vertebra centrum. The carotid artery stenosis section of three cases is located at the middle lower edge of the first cervical vertebrae. Clinical evaluation was performed from surgical process, time of postoperative drainage tube removal, perioperative complications and follow-up survey on the serious numbness at the surgical site one month, three months and six months after the surgery. There are 0 cases of postoperative death, 0 cases of cerebral hemorrhage cerebral infarction, 1 case of myocardial infarction, 2 cases of Hypoglossal nerve temporary injury, 0 case of infection of incisional wound and incidence rates of serious numbness in postoperative follow-up surgical area one month, 3 months and 6 months are 23.81%, 19.05% and 9.52% respectively. The cranial nerves and surrounding muscle groups at the far end of carotid artery stenosis and carotid artery can be fully disposed via anterior cervical triangle posterior vena jugularisinterna by utilizing microsurgery-technique and suspended carotid artery technology conveniently and completely to avoid cutting the corresponding branches of vena jugularisinterna and too much anatomy of anterior triangle lymph fatty tissue to properly avoid postoperative edema at the surgical area, cranial nerve injuries and other complications. It is a convenient, efficient, safe and effective CEA approach. .
本文探讨经颈前三角后内侧静脉入路显微镜下颈动脉内膜切除术（CEA）联合颈动脉悬吊术治疗高位复杂颈动脉狭窄的手术技巧及临床疗效。对21例患者的临床资料进行回顾性分析。颈动脉狭窄段远端位于第二颈椎椎体下缘以上，3例颈动脉狭窄段位于第一颈椎中下缘。从手术过程、术后引流管拔除时间、围手术期并发症以及术后1个月、3个月和6个月手术部位严重麻木的随访调查等方面进行临床评估。术后死亡0例，脑出血脑梗死0例，心肌梗死1例，舌下神经暂时性损伤2例，切口感染0例，术后随访手术区域1个月、3个月和6个月严重麻木发生率分别为23.81%、19.05%和9.52%。利用显微外科技术和颈动脉悬吊技术，经颈前三角后内侧静脉入路可方便、完整地充分显露颈动脉狭窄远端的脑神经及周围肌群，避免切断颈内静脉相应分支及过多解剖颈前三角淋巴脂肪组织，妥善避免手术区域术后水肿、脑神经损伤等并发症。是一种方便、高效、安全、有效的CEA手术入路。
