颈动脉支架植入术与颈动脉内膜剥脱术治疗重度颈动脉硬化性狭窄效果对比
常红娟 高士钦 王 兵 梁卢允 孟 欣 陈 燕
新乡市第二人民医院，河南 新乡 453002
通信作者：常红娟
【摘要】 目的 对比颈动脉支架植入术（carotid artery stenting，CAS）与颈动脉内膜剥脱术（carotid endarterectomy，CEA）治疗重度颈动脉硬化性狭窄的临床效果。方法 入组 70 例重度颈动脉硬化性狭窄患者，其中 CAS 组 40 例采用颈动脉支架植入术，CEA 组 30 例采用颈动脉内膜剥脱术，对比分析两种方式的治疗效果。结果 CEA 组心脏不良事件发生率（20.0%）高于 CAS 组（2.5%），差异有统计学意义（χ2 =4.051，P=0.044）。CEA 组神经性损伤及切口并发症发生率（16.7%，16.7%）均高于 CAS 组（0，0），差异有统计学意义（χ2 =4.887，P=0.027）。CAS 组和 CEA 组术后 1 a 再狭窄率差异无统计学意义（χ2=0.000，P=1.000）。结论 颈动脉支架植入术后不良反应少，对患者的损伤较小，推荐使用颈动脉支架植入术治疗重度颈动脉硬化性狭窄。
【关键词】 重度颈动脉硬化性狭窄；颈动脉支架植入；颈动脉内膜剥脱术；安全性；不良事件
【中图分类号】 R743.1 【文献标识码】 A 【文章编号】 1673-5110 （2022） 05-0614-04
基金项目：新乡市科技攻关计划项目（编号：GG2020050）
DOI：10.12083/SYSJ.220367
Comparative of CAS and CEA in the treatment of severe carotid atherosclerotic stenosis
CHANG Hongjuan，GAO Shiqin，WANG Bing，LIANG Luyun，MENG Xin，CHEN Yan
The Second People’s Hospital of Xinxiang，Xinxiang 453002，China
Corresponding author：CHANG Hongjuan
【Abstract】 Objective To compare the clinical effects of carotid artery stenting（CAS）and carotid endarterectomy（CEA）in the treatment of severe carotid atherosclerotic stenosis. Methods Seventy patients with severe carotid atherosclerotic stenosis were enrolled, of which 40 patients in the CAS group were treated by carotid stent implantation, and 30 patients in the CEA group were treated by carotid endarterectomy. The therapeutic effects of the two methods were compared and analyzed. Results The incidence of adverse cardiac events in the CEA group（20.0%）was higher than that in the CAS group（2.5%），and the difference was statistically significant（χ2=4.051，P=0.044）. The incidence of neurological injury and incision complications in the CEA group （16.7%，16.7%）were higher than those in the CAS group（0，0），and the difference was statistically significant（χ2=4.887，P=0.027）. There was no significant difference in the restenosis rate at 1-year between the CAS group and CEA group（χ2=0.000，P=1.000）. Conclusion Carotid artery stent implantation has fewer adverse reactions after surgery and less damage to patients. Carotid artery stent implantation is recommended for treatment.
【Key words】 Severe carotid atherosclerotic stenosis；Carotid artery stenting；Carotid endarterectomy；Security；Adverse event
