颈动脉狭窄与颈动脉内膜剥脱术

颈动脉狭窄和闭塞是最常见的老年病之一,由于脑部供血不足,早期主要表现为嗜睡、一过性晕厥或黑蒙,随着狭窄的加重,随时有可能发生脑梗死,导致偏瘫或死亡。颈动脉内膜剥脱术(CEA)可以有效预防和治疗缺血性脑卒中。术前需进行头部CT扫描、磁共振、颈动脉超声或者数字减影血管造影检查。有临床症状的颈动脉狭窄患者,狭窄程度超过50%,无临床症状的颈动脉狭窄患者,狭窄程度超过60%可作为CEA的主要手术指征。全身麻醉仍是CEA的主要麻醉方法,局部麻醉亦有有利之处。补片成型以及应用转流被大多数学者所采纳。与CEA相比,血管内治疗仍处在实验阶段,尚不能取代CEA在预防缺血性脑卒中方面的主导地位。

Carotid Artery Stenosis and Carotid Endarterectomy

Carotid artery stenosis and occlusion are one of the common senile diseases,of which the earlier manifestation are drowsiness,syncope or amaurosis fugax,further more,with the aggravation of stenosis,cerebral infarction maybe happen at any time,which will then result in semiplegia or death.CEA can effective prevent and treat ischemic brain stroke.Patients needing operation should have examination of head CT,MRI,carotid ultrasound examination or digital subtraction angiography(DSA).Patients with carotid stenosis above 50% having clinical manifestation or with carotid stenosis above 60 % having no clinical manifestation are the main sugery indication.General anaesthesia is still the main anaesthesia method of CEA,toponarcosis also has its own advantages.Patch angioplasty and shunting in carotid artery surgery have been adopted by the major scholars.Contrasting with CEA,endovascular treatment is still in experimental stage,which can not replace the leading place of CEA in the prevention of ischemic brain stroke.