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題 名 | Retrospective Study of Carotid Endarterectomy for Cerebrovascular Insufficiency=頸動脈內膜截除術治療缺血性腦血管疾病的研究 |
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作 者 | 賴曉亭; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 24:3 民80.05-06 |
頁 次 | 頁669-674 |
分類號 | 416.291 |
關鍵詞 | 頸動脈內膜截除術; 缺血性腦血管疾病; |
語 文 | 英文(English) |
中文摘要 | 榮民總醫院心臟血管外科從1983年8月到1990年7月,有77位共有95例頸動脈有阻塞性病兆患者接受頸動脈內膜截除術以治療缺血性腦血管疾病。男性患者73位,女性僅4位。平均年齡為65±6.0歲,年齡範圖從50歲到84歲,共有69例接受單純性縫合頸動脈內膜截除術,而男26例接受靜脈片狀縫合頸動脈內膜截除術。 早期結果顯示77位患者有75位存活,在65例頸動脈缺血症狀患者有57例顯現出症狀完全改善佔87.8%,在12例無頸動脈缺血症狀患者,術後有11例顯現完全進步佔91.7%。頸動脈內膜截除術後30天內有兩例患者不幸死亡,另一例發生輕微中風,急性術後死亡率為2.6%,術後中風率僅1.5%。手術後長期追蹤顯示僅5例患者發生復發性頸動脈狹窄佔7.4%,有1例1年後發生暫時性腦缺血症狀佔1.5%,並成功的再接受手術治療。此5例都僅接受單純性縫合頸動脈內膜截除術的患者,復發性頸動脈狹窄發生時間從8個月到3年。在26例實施片狀縫合頸動脈內膜截除術患者中並無發生復發性頸動脈狹窄。追蹤7年,期間共有10例因不同原因死亡,後期死亡率為13%。 頸動脈內膜截除術對高度頸動脈狹窄患者不論有或無腦缺血性症狀,手術後都可以預防日後腦中風的發生。依照我們的經驗顯示,實施頸動脈內膜截除術的危險性低且長期追蹤情況良好。我們認為若能適當選擇病患對成功的頸動脈血管外科重建術是必須的。 |
英文摘要 | From August 1983 through July 1990, a total of 77 consecutive patients with 95 carotid lesions underwent carotid endarterectomy (CEA) for cerebrovascular insufficiency at Division of Cardiovascular Surgery of the Veterans General Hospital. The patient consisted of 73 men and 4 women. The mean age was 65±6.0 years (Age range from 50 to 84 years). Out of these 77 patients, 69 underwent simple closure for CEA, 26 received venous patch closure for CEA. The early results of the 77 patients revealed 75 survivors. 57 (87.8%) in the total 65 symptomatic patients experienced immediate and marked relief of symptoms. 11 (91.7%) of the 12 asymptomatic patients had no attack on neurologic symptoms. The minor complications rate was 19.5%, which related to the cervical wound exposure. Two died and one had permanent neurologic deficit within 30 days after CEA. The perioperative stroke rate was 1.5% and the acute operative mortality rate was 2.6%. Five patients out of the 69(7.4%) with simply closuring procedure for carotid artery developed recurrently carotid stenosis with one patient (1.5%) having TIA. The patient had the second successfully carotid surgery. The onset of recurrent stenosis was ranged from 8 months to 3 years postoperatively. No recurrently carotid stenosis occured in the 26 with venously patching and closuring procedure. There were 10 non-related with surgicallate deaths and the late mortality rate was 13%. CEA for symptomatic or asymptomatic patients with high grade stenosis has became recognized in relieving the symptoms of TIAs and in the preventing strokes. According to our experience, the risk of CEA is low and the long-term follow-up of such patient is good. We believe that a carefully selected patient is necessary for the successful technique of the vascular surgery. |
本系統中英文摘要資訊取自各篇刊載內容。