摘要
目的比较颈动脉狭窄患者颈动脉支架植入术和内膜剥脱术后并发症及近远期疗效。方法选取2020年7月至2021年12月在郑州市中心医院接受手术治疗的158例颈动脉狭窄患者作为研究对象,根据手术方式分为内膜剥脱组和支架植入组,各79例,内膜剥脱组患者在全麻下行颈动脉内膜剥脱术,支架植入组患者在局麻下行颈动脉支架植入术。记录两组患者术后并发症的发生情况,采用蒙特利尔认知评估量表(MoCA)对两组术前和术后1、3个月时认知功能进行评价,记录术后3个月和术后1 a内两组再狭窄、脑卒中和死亡的发生例数。结果支架植入组患者术后切口并发症、肺部感染和低血压/心动过缓的发生率均低于内膜剥脱组,差异有统计学意义(P<0.05)。术后1、3个月时,两组患者MoCA评分均较术前相比有升高(P<0.05),但是两组各时间点MoCA评分差异无统计学意义,并且各时间点与手术方式之间不存在交互作用(P>0.05)。术后随访3个月和1 a时,两组患者再狭窄、脑卒中和死亡的发生率差异均无统计学意义(P>0.05)。结论颈动脉支架植入术与内膜剥脱术改善颈动脉狭窄近远期预后的效果相当,并均可促进患者认知功能的恢复,但是支架植入术能够更好地降低颈动脉狭窄患者围手术期并发症发生风险,手术安全性较好。
Objective To compare the postoperative complications and short-term and long-term effects of carotid artery stenting and carotid endarterectomy in patients with carotid artery stenosis.Methods A total of 158 patients with carotid artery stenosis who received surgical treatment in Zhengzhou Central Hospital from July 2020 to December 2021 were selected as the research objects and divided into endarterectomy group and stenting group according to surgical methods,79 cases in each group.The patients in the endarterectomy group underwent carotid endarterectomy under general anesthesia,while the patients in the stenting group underwent carotid artery stenting under local anesthesia.The incidences of postoperative complications in the two groups were recorded.The Montreal cognitive assessment(MoCA)was evaluated the cognitive function of the two groups before surgery,1st month and 3rd month after surgery.The incidences of restenosis,stroke and death in the two groups were recorded at 3rd month and 1st year after surgery.Results The incidences of postoperative incision complications,pulmonary infection and hypotension/bradycardia in the stenting group were lower than those in the endarterectomy group,the difference was statistically significant(P<0.05).At 1st month and 3rd month after surgery,MoCA scores in both groups were higher than those before surgery(P<0.05),but there was no significant difference at each time point between the two groups,and there was no interaction between each time point and surgical method(P>0.05).There was no significant difference in the incidences of restenosis,stroke and death between the two groups at 3rd month and 1st year after surgery(P>0.05).Conclusion Carotid artery stenting and endarterectomy have similar efficacy in improving carotid artery stenosis in the short-term and long-term prognosis,and both can promote the recovery of cognitive function.But carotid artery stenting can better reduce the risk of perioperative complications in patients with carotid artery stenosis,with good surgical safety.
作者
娄浩然
LOU Haoran(Department of Vascular Surgery,Zhengzhou Central Hospital,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2023年第14期2513-2516,共4页
Henan Medical Research
基金
河南省医学科技攻关计划联合共建项目(LHGJ20200342)。
作者简介
通信作者:娄浩然,E-mail:lhrxgwk@163.com。
