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目的探讨颈动脉内膜剥脱术(CEA)在颈动脉重度狭窄患者中的应用价值。方法选取2014年1月-2015年12月惠州市第一人民医院联合龙门县人民医院收治的60例重度颈动脉狭窄患者为研究对象,随机分为CEA组与颈动脉支架成形术(CAS)组各30例。对比两组患者围手术期并发症发生率、术后3个月内心血管事件发生率,术后随访12个月,观察两组术侧颈动脉再狭窄的发生情况。结果 CEA组围术期并发症发生率为16.7%低于CAS组的20.0%,组间比较差异无统计学意义(P>0.05)。术后3个月CEA组共发生4例心血管事件发生低于CAS组的6例,组间比较差异无统计学意义(P>0.05)。随访期间CAS组出现颈动脉再狭窄4例,CEA组未见颈动脉再狭窄发生,组间比较差异有统计学意义(P<0.05)。结论 CAS和CEA均可视为治疗重度颈动脉狭窄的有效方式,但后者操作简便,术中无严重并发症,且术后再狭窄发生率较低,因此在患者条件允许的情况下,可优先采用此术式。
Objective To investigate the value of carotid endarterectomy (CEA) in patients with severe carotid stenosis. Methods Sixty patients with severe carotid stenosis treated by Huizhou First People’s Hospital and Longmen People’s Hospital from January 2014 to December 2015 were selected and randomly divided into two groups: CEA group and carotid stenting (CAS) group 30 cases each. The incidence of perioperative complications, the incidence of cardiovascular events within 3 months after operation and the follow-up of 12 months were compared between the two groups. The incidence of carotid restenosis was observed in two groups. Results The incidence of perioperative complications in CEA group was 16.7% lower than that in CAS group (20.0%). There was no significant difference between the two groups (P> 0.05). At 3 months after operation, 4 cases of cardiovascular events in CEA group were lower than those in CAS group. There was no significant difference between the two groups (P> 0.05). In the CAS group, 4 cases of carotid restenosis occurred during the follow-up, while no carotid restenosis occurred in the CEA group. The difference between the two groups was statistically significant (P <0.05). Conclusions Both CAS and CEA can be regarded as an effective method for the treatment of severe carotid artery stenosis. However, the latter is simple and convenient in operation with no serious complications during operation and the incidence of postoperative restenosis is low. Therefore, under the condition of patients, Priority to use this technique.