Yang Y G, Chen Z, Kou L, Tang X B, Wu Z M, Liu H, Wang S
Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2019 Jun 4;99(21):1636-1640. doi: 10.3760/cma.j.issn.0376-2491.2019.21.009.
To evaluate the related risk factors of cerebrovascular complications after carotid endarterectomy (CEA) and to improve the efficacy of CEA in the treatment of ischemic stroke. The clinical data of 295 patients with atherosclerotic carotid artery stenosis who underwent CEA in the Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University from January 2013 to March 2017 were retrospectively analyzed. As the results of the single-factor analysis of logistics, severe lower limb artery stenosis (5.667, 0.017), systolic blood pressure before the carotid artery clamping (6.659, 0.010), diastolic blood pressure before the carotid artery clamping (3.981, 0.046), stump pressure (5.359, 0.021), diastolic blood pressure after surgery (9.550, 0.002), diastolic blood pressure of the first day after surgery (7.932, 0.005) were influencing factors of postoperative cerebrovascular complications after CEA. The results of multi-factor analysis of logistic regression indicated that diastolic blood pressure before the carotid artery clamping (0.953, 0.024) and stump pressure to basic systolic blood pressure index (SSI)>0.25 (0.086, 0.049) were independent risk factors for postoperative cerebrovascular complications after CEA. Systolic blood pressure before carotid artery clamping and SSI>0.25 are independent risk factors for postoperative cerebrovascular complications after CEA. Close follow-up and drug treatment for patients after CEA might be beneficial to reduce postoperative carotid artery restenosis.
评估颈动脉内膜切除术（CEA）后脑血管并发症的相关危险因素，提高CEA治疗缺血性卒中的疗效。回顾性分析2013年1月至2017年3月在首都医科大学附属北京安贞医院血管外科行CEA的295例动脉粥样硬化性颈动脉狭窄患者的临床资料。作为逻辑单因素分析结果，严重下肢动脉狭窄（5.667，0.017）、颈动脉夹闭前收缩压（6.659，0.010）、颈动脉夹闭前舒张压（3.981，0.046）、残端压力（5.359，0.021）、术后舒张压（9.550，0.002）、术后第一天舒张压（7.932，0.005）是CEA术后脑血管并发症的影响因素。逻辑回归多因素分析结果显示，颈动脉夹闭前舒张压（0.953，0.024）和残端压力与基础收缩压指数（SSI）>0.25（0.086，0.049）是CEA术后脑血管并发症的独立危险因素。颈动脉夹闭前收缩压和SSI>0.25是CEA术后脑血管并发症的独立危险因素。CEA术后对患者进行密切随访和药物治疗可能有助于减少术后颈动脉再狭窄。
