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[颈动脉内膜切除术治疗脑缺血:手术结果及晚期神经并发症的随访研究]

[Carotid endarterectomies for cerebral ischemia: a follow up study of surgical results and late neurologic complications].

作者信息

Sakurai T, Yamada I, Ikezawa T, Shionoya S, Nakata Y

机构信息

First Department of Surgery, Nagoya University School of Medicine, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Mar;89(3):431-6.

PMID:3393133
Abstract

Twenty five carotid endarterectomies were performed in 24 patients with cerebral ischemia due to atherosclerosis. Four of these patients were asymptomatic, 7 suffered from hemispheric TIA (hemispheric attack group), 7 suffered from nonhemispheric TIA (nonhemispheric attack group) and other 6 had previous completed stroke (completed stroke group). The average length of follow-up study was two and half years with a range of 2 months to 6 years. Completed strokes occurred in 1 patient following the operation and in 3 patients during the follow-up period (16.7%). Two patients were reoperated upon because of recurrent carotid stenosis (8.3%). Four patients continued to have neurologic symptoms postoperatively. Ultimately 10 of 24 patients had some neurologic complications even following carotid endarterectomies (41.7%). The first postoperative year was the worst period because almost all late neurologic complications occurred in that time. Kaplan-Meier's analysis demonstrated a relatively favorable result in the hemispheric attack group among these 3 groups. The completed stroke group was followed by that and the nonhemispheric attack group was proved to be the worst, although there was no statistical significance.

摘要

对24例因动脉粥样硬化导致脑缺血的患者实施了25次颈动脉内膜切除术。其中4例患者无症状,7例患有半球性短暂性脑缺血发作(半球发作组),7例患有非半球性短暂性脑缺血发作(非半球发作组),另外6例曾有过脑卒中病史(脑卒中组)。随访研究的平均时长为两年半,范围为2个月至6年。术后有1例患者发生脑卒中,随访期间有3例患者发生脑卒中(16.7%)。2例患者因复发性颈动脉狭窄接受了再次手术(8.3%)。4例患者术后仍有神经症状。最终,24例患者中有10例即使在接受颈动脉内膜切除术后仍出现了一些神经并发症(41.7%)。术后第一年情况最差,因为几乎所有晚期神经并发症都发生在这一时期。Kaplan-Meier分析显示,在这三组中,半球发作组的结果相对较好。其次是脑卒中组,非半球发作组结果最差,尽管差异无统计学意义。

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