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[颈动脉血栓内膜切除术后5年随访]

[5-year follow-up after endarterectomy of carotid artery thrombosis].

作者信息

Stiegler H, Forssman T, Standl E, Maschler C, Baumann G

机构信息

III. Medizinische Abteilung, Städtisches Krankenhaus München-Schwabing.

出版信息

Dtsch Med Wochenschr. 1988 Dec 23;113(51-52):1987-93. doi: 10.1055/s-2008-1067924.

Abstract

The long-term results of carotid endarterectomy were analysed in 119 patients, operated on between January 1979 and December 1980 (135 endarterectomies; preoperative data analysed retrospectively). 43 patients had been in stage I, 39 in stage IIa, 13 in stage IIb, 4 in stage III, and 20 in stage IV. Perioperative mortality was 0.8%, while hospital mortality was 2.5%. Transitory perioperative neurological deficits occurred in 4.2% of all patients, but no permanent ones. Five years postoperatively 44.5% had died, nearly half (43.4%) of cardiovascular disease. Cerebrovascular disease and tumour each caused 15% of deaths. During the five-year follow-up period 12% of all patients had had transitory ischaemic attacks; 16% had suffered a stroke (in 63% on the operated side). With a high prevalence of risk factors, only the quality of diabetic control (mortality rate of well controlled diabetes 38%, of poorly controlled 70%) and the risk factors heart failure and vascular occlusive disease had a significant influence on the mortality rate. But the mortality rate was significantly lowered with the use of platelet aggregation inhibitors (41.6% vs 72.7%).

摘要

对119例在1979年1月至1980年12月期间接受手术的患者(共进行了135次动脉内膜切除术;术前数据进行回顾性分析)的颈动脉内膜切除术长期结果进行了分析。43例患者处于I期,39例处于IIa期,13例处于IIb期,4例处于III期,20例处于IV期。围手术期死亡率为0.8%,而住院死亡率为2.5%。所有患者中有4.2%出现短暂性围手术期神经功能缺损,但无永久性缺损。术后五年,44.5%的患者死亡,近一半(43.4%)死于心血管疾病。脑血管疾病和肿瘤各导致15%的死亡。在五年随访期内,所有患者中有12%发生过短暂性脑缺血发作;16%发生过中风(63%发生在手术侧)。由于危险因素普遍存在,只有糖尿病控制质量(血糖控制良好者死亡率为38%,控制不佳者为70%)以及心力衰竭和血管闭塞性疾病等危险因素对死亡率有显著影响。但使用血小板聚集抑制剂可显著降低死亡率(41.6%对72.7%)。

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