Sege D, Nagel W, Stieger R, Pommer S
Gefäss- und Thoraxchirurgie, Klinik für Chirurgie, Kantonsspital St. Gallen.
Swiss Surg. 1997;3(1):30-4.
The 5-year results following carotid endarterectomy at our institution were analysed retrospectively. The aim of this study was to compare our results with those published in the ECST and NASCET studies as a measure of quality control. We studied the outcome of 101 carotid endarterectomies which were performed between 1989 and 1993 in 90 patients. 74 operations were carried out in "symptomatic" and 27 in "asymptomatic" patients. The standard anaesthetic procedure was a cervical plexus block, which was completed in 87% of all operations. The 84 surviving patients on December the 31th 1993 were all followed up with a clinical and directional Doppler examination in our angiologic outpatient clinic during the first half of 1994. The perioperative stroke rate was 1.98% for the whole group and 2.7% for the "symptomatic" group. The cumulative stroke rate for a period of three years (measured by the Kapplan-Meier method) amounted to 3% (1% per year); the cumulative stroke rate for the "symptomatic" group was 4% in a two year period (2% per year). The results and outcome of carotid endarterectomy at our institution are comparable to the ECST and NASCET studies regarding perioperative mortality, perioperative stroke rate and rate of ipsilateral stroke during the first 2 years after operation.
我们对本机构行颈动脉内膜切除术的5年结果进行了回顾性分析。本研究的目的是将我们的结果与欧洲颈动脉外科试验（ECST）和北美症状性颈动脉内膜切除术试验（NASCET）发表的结果进行比较，以此作为质量控制的一种手段。我们研究了1989年至1993年间在90例患者中进行的101例颈动脉内膜切除术的结果。74例手术针对“有症状”患者，27例针对“无症状”患者。标准麻醉方法为颈丛阻滞，87%的手术采用此方法。1993年12月31日存活的84例患者于1994年上半年在我们的血管门诊接受了临床和定向多普勒检查随访。全组围手术期卒中发生率为1.98%，“有症状”组为2.7%。三年累积卒中发生率（采用Kaplan-Meier法测量）为3%（每年1%）；“有症状”组两年累积卒中发生率为4%（每年2%）。在围手术期死亡率、围手术期卒中发生率以及术后头两年同侧卒中发生率方面，本机构颈动脉内膜切除术的结果与ECST和NASCET研究的结果相当。
