Morawetz R B, Zeiger H E, McDowell H A, McKay R D, Varner P D, Gelman S, Halsey J H
Surgery. 1984 Aug;96(2):184-9.
One hundred twenty-nine consecutive carotid endarterectomies performed for atherosclerotic ulcerative stenosis without the use of intraoperative shunting were analyzed prospectively in an effort to determine the significance of intraoperative ischemia. Intraoperative EEG and regional cerebral blood flow measurements were used to monitor these patients. Ten of the patients were excluded because of inadequate data, but none of these 10 patients experienced a complication. Factors analyzed included preoperative risk assessment according to the Mayo Clinic system of Sundt et al., intraoperative regional cerebral blood flow measurements, and intraoperative EEG changes. The overall mortality rate was 2.5%, the major morbidity rate was 2.5%, the minor morbidity rate was 1.7%, and the rate of transient neurologic dysfunction was 1.7%. The patients' preoperative state as determined according to the Mayo Clinic system of Sundt et al. was more useful in identifying patients at risk than was intraoperative EEG and regional cerebral blood flow monitoring.
为确定术中缺血的意义，我们对129例因动脉粥样硬化溃疡性狭窄而进行的连续颈动脉内膜切除术患者进行了前瞻性分析，术中未使用分流术。术中采用脑电图（EEG）和局部脑血流测量来监测这些患者。10例患者因数据不足被排除，但这10例患者均未发生并发症。分析的因素包括根据Sundt等人的梅奥诊所系统进行的术前风险评估、术中局部脑血流测量以及术中EEG变化。总死亡率为2.5%，主要发病率为2.5%，次要发病率为1.7%，短暂性神经功能障碍发生率为1.7%。根据Sundt等人的梅奥诊所系统确定的患者术前状态，在识别有风险的患者方面比术中EEG和局部脑血流监测更有用。
