症状性Riles 1A型颈总动脉闭塞的血运重建及疗效

发布时间：2018-10-18 20:44

【摘要】：目的:评价Riles 1A型颈总动脉闭塞(CCAO)的血运重建方式及效果。方法:对2012年8月—2015年6月9例症状性Riles 1A型CCAO患者行血运重建,其中旁路转流5例,原位重建4例。结果:手术均顺利完成,所有患者术后症状消失或明显好转。2例(2/9)出现过度灌注综合征,经严格控制血压、脱水降颅压治疗后好转,无脑出血等严重并发症。随访期间患者一般情况良好,症状明显改善或消失,1例行颈动脉内膜剥脱术联合颈动脉支架置入术患者术后6个月经超声发现支架近端轻中度狭窄(50%),但患者无自觉症状,未予处理;1例合并冠心病患者术后17个月因心肌梗塞死亡。结论:症状性Riles 1A型CCAO患者行血运重建安全有效;手术方式需个体化选择,原位重建应在有条件医疗机构积极开展。
[Abstract]:Objective: to evaluate the revascularization of Riles 1A common carotid artery occlusion (CCAO). Methods: blood revascularization was performed in 9 patients with symptomatic Riles 1A type CCAO from August 2012 to June 2015, including 5 patients with bypass flow and 4 patients with in situ reconstruction. Results: the operation was completed successfully and the symptoms disappeared or improved obviously in all the patients. 2 cases (2 / 9) developed hyperperfusion syndrome. After strict blood pressure control, dehydration and intracranial pressure reduction treatment, no serious complications such as cerebral hemorrhage and so on. During the follow-up period, the patients were generally in good condition and their symptoms were obviously improved or disappeared. One patient who received carotid endarterectomy combined with carotid stenting was found to have mild to moderate stenosis at the proximal end of the stent (50%) by ultrasonography 6 years after the operation, but the patient had no conscious symptoms. One patient with coronary heart disease died of myocardial infarction 17 months after operation. Conclusion: it is safe and effective for patients with symptomatic Riles 1A type CCAO to perform revascularization, and the operative method should be individualized, and in situ reconstruction should be carried out actively in conditional medical institutions.
【作者单位】：湖北省荆州市第一人民医院血管外科;郑州大学第一附属医院腔内血管外科;
【基金】：国家自然科学基金资助项目(81270393)
【分类号】：R654.3

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