颈动脉狭窄的显微外科治疗

目的:评价颈动脉内膜剥脱术治疗颅外颈动脉狭窄的疗效,以及经颅多普勒超声(TCD)、微血管多普勒超声(MVD)应用的价值。方法:回顾性分析2012年5月至2013年5月采用颈动脉内膜剥脱术治疗的19例颅外颈动脉狭窄的资料。均伴有不同程度的脑缺血症状。颈动脉狭窄程度2例中度狭窄,17例重度狭窄。同时行颈动脉内膜剥脱术均在显微镜下操作。1例采用补片成形。18例术中采用TCD及MVD监测下完成,1例未采用超声监测。结果:手术成功率为100%,无死亡率。术前脑缺血症状术后患者均有不同程度的恢复。均未发现过度灌注的并发症。结论:颈动脉内膜剥脱术治疗颅外颈动脉狭窄是一种安全、有效的措施;MVD及TCD监测对于显微手术有着重要意义。

Microsurgical Treatment of Carotid Stenosis

Objective:To evaluate the effect of carotid endarterectomy on extracranial carotid artery stenosis and the role of transcranial Doppler (TCD) and Microvascular Doppler (MVD) in carotid endarterectomy.Methods:From May 2012 to May 2013, 19 patients were selected in our hospital. All patients had symptoms of cerebral ischemia. 2 patients had middle carotid artery stenosis and the others had severe carotid artery stenosis. All patients were under microsurgery. Only 1 patient had angioplasty with arterial patch. TCD and MVD monitoring was used in the surgery of 18 patients while 1 patient was not.Results:Surgery was successful in all patients. Cerebral ischemic symptoms improved to a certain degree in all the 19 preoperative symptomatic patients. No hyperperfusion was found in these patients.Conclusion:Carotid endarterectomy is a safe and effective procedure for treating extraeranial carotid artery stenosis. MVD and TCD monitoring is valuable in microsurgery.