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颈动脉内膜切除术(CEA)的适应症与结果:单中心经验

Indications and Outcome of Carotid Endarterectomy (CEA): A Single Centre Experience.

作者信息

Elshikhawoda Mohamed S M, Jararaa Sohaib, Tan Steven H S, Mohamed Ahmed Hashim Ahmed, Abdalaziz Doaa Abdalaziz Salih, Roble Abdillahi Ahmed, Okaz Mahmoud, Ahmad Waseem, Elsanosi Abdelrhman, Jararah Hassan

机构信息

Vascular Surgery, Glan Clwyd Hospital, Rhyl, GBR.

Surgery, University Hospital of Wales, Cardiff, GBR.

出版信息

Cureus. 2023 Dec 21;15(12):e50930. doi: 10.7759/cureus.50930. eCollection 2023 Dec.

Abstract

Background Stroke is a prevalent ailment that impacts a substantial number of individuals globally, resulting in both physical impairment and mortality. One of its major causes is carotid artery stenosis. The symptoms and degree of stenosis are key indications for carotid endarterectomy (CEA). In this study, we highlight the indications and outcomes of carotid endarterectomy in our center. Methods This is a descriptive, retrospective, observational study. Data of patients who underwent CEA at Glan Clwyd Hospital from January 2018 to January 2023 was retrieved. The study sample consisted of patients diagnosed with symptomatic carotid artery stenosis who had CEA at Glan Clwyd Hospital. The data was analyzed using statistical software SPSS (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). Results A total of 150 patients were enrolled in the study. A majority of the patients were male, accounting for 69.3% (n = 104), and had a mean age of 71.1 ± 9.9 standard deviation. A majority of the patients were smokers (48.7%) and had additional medical conditions, including hypertension (34%), ischemic heart disease (17.3%), chronic obstructive pulmonary disease (73.3%), and diabetes (46.7%). Nevertheless, the remaining comorbidities were less common. The outcome of the CEA among the patients was cardiac event 3.3% (n = 5); transient ischemic attack (TIA) 3.3% (n = 5); stroke 0.6% (n = 1); hemorrhage 2.6% (n = 4); surgical site infection 2% (n = 3); perioperative mortality 1.3% (n = 2); and cranial nerve injury 1.3% (n = 2). However, no complications were reported in most of the patients, 85.6% (n = 128). Conclusion An endarterectomy is quite advantageous for treating symptomatic stenosis. The findings can be applied to patients who are physically suitable for surgery. The efficacy of endarterectomy is contingent upon not only the severity of carotid stenosis but also various other parameters, such as the time elapsed between the presenting event and the surgical intervention, as well as the patient's overall medical condition. However, the CEA is the gold standard in surgical management for symptomatic carotid disease.

摘要

背景

中风是一种常见疾病,在全球影响着大量人群,会导致身体残疾和死亡。其主要病因之一是颈动脉狭窄。狭窄的症状和程度是颈动脉内膜切除术(CEA)的关键指征。在本研究中,我们重点介绍了我们中心颈动脉内膜切除术的指征和结果。

方法

这是一项描述性、回顾性、观察性研究。检索了2018年1月至2023年1月在格兰克莱德医院接受CEA手术的患者数据。研究样本包括在格兰克莱德医院被诊断为有症状颈动脉狭窄并接受CEA手术的患者。使用统计软件SPSS(IBM公司。2012年发布。适用于Windows的IBM SPSS Statistics,版本21.0。纽约州阿蒙克:IBM公司)对数据进行分析。

结果

共有150名患者纳入研究。大多数患者为男性,占69.3%(n = 104),平均年龄为71.1±9.9标准差。大多数患者为吸烟者(48.7%),并患有其他疾病,包括高血压(34%)、缺血性心脏病(17.3%)、慢性阻塞性肺疾病(73.3%)和糖尿病(46.7%)。然而,其余合并症不太常见。患者CEA手术的结果为:心脏事件3.3%(n = 5);短暂性脑缺血发作(TIA)3.3%(n = 5);中风0.6%(n = 1);出血2.6%(n = 4);手术部位感染2%(n = 3);围手术期死亡率1.3%(n = 2);以及颅神经损伤1.3%(n = 2)。然而,大多数患者(85.6%,n = 128)未报告并发症。

结论

内膜切除术对于治疗有症状的狭窄非常有利。这些发现可应用于身体适合手术的患者。内膜切除术的疗效不仅取决于颈动脉狭窄的严重程度,还取决于其他各种参数,如发病事件与手术干预之间的时间间隔以及患者的整体健康状况。然而,CEA是有症状颈动脉疾病手术治疗的金标准。

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