摘要
目的分析糖尿病与非糖尿病患者颈动脉内膜切除术（CEA）围手术期临床结果，探讨CEA在糖尿病患者中的安全性。方法回顾性分析2006年1月至2014年9月在北京协和医院血管外科572例接受CEA手术患者临床资料。根据患者是否合并糖尿病，分为糖尿病组和非糖尿病组，比较两组患者一般情况、术中指标及围手术期并发症。结果572例患者中184例（32．2％）合并糖尿病；糖尿病组术前合并冠心病（30．4％比18．6％）、高脂血症（50．5％比36．6％）及外周动脉疾病（39．7％比27．3％）的患者比例显著高于非糖尿病组（均P〈0．05）；糖尿病组与非糖尿病组患者围手术期心肌梗死（0．5％比0．8％）、脑卒中（1．6％比1．8％）、病死率（0．5％比0．3％）差异均无统计学意义（均P〉0．05）。平均随访42个月结果显示，糖尿病组与非糖尿病组心肌梗死（4．3％比3．4％）、脑卒中（1．8％比1．7％）及其相关死亡（1．1％比0．9％）、术后再狭窄率（2．9％比3．1％）差异均无统计学意义（均P〉0．05）。结论糖尿病患者在严格围手术期管理的前提下，可安全实施颈动脉内膜切除术。
Objective To compare perioperative outcome of carotid endarterectomy （CEA） between diabetic and non-diabetic patients and discuss the safety of CEA in diabetic patients. Methods A total of 572 patients with carotid stenosis who underwent CEA from Juanuary 2006 to September 2014 in Peking Union Medical Colloge Hospital were collected and analyzed retrospectively. The patients were distributed into diabetes mellitus （DM） group and non-DM group according to the comorbidities. Their baseline characteristics, intraoperative index and major complications in perioperative period were analyzed and compared. Results Of 572 cases, 184 had DM （32. 2% ）. Diabetic patients more frequently had a history of coronary artery disease （ 30. 4% vs 18.6% ）, peripheral artery disease （ 39.7% vs 27.3% ）, and hyperlipemia （50. 5 % vs 36. 6% ） than non-diabetic patients （all P 〈 0. 05 ）. The incidence of perioperative myocardial infarction （0. 5% vs 0. 8% ）, stroke （ 1.6% vs 1.8% ） and death （0. 5% vs 0. 3% ） did not differ between two groups （ all P 〉 0. 05 ）. Data of follow-up was available in 89. 6% of patients, with a median duration of 42 months. The incidence of myocardial infarction （4. 3% vs 3.4% ） , stroke （1.8% vs 1.7% ）, death （ 1.1% vs 0. 9% ）, and restenosis （2. 9% vs 3. 1% ） did not differ between two groups （ all P 〉 0.05）. Conclusion DM does not increase the risk of perioperative complications and impair the longterm outcomes after CEA if the patients are appropriately evaluated and treated in perioperative period.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第44期3549-3553,共5页
National Medical Journal of China
基金
国家自然科学基金（81470585）
关键词
颈动脉狭窄
糖尿病
颈动脉内膜切除术
围手术期
Carotid stenosis
Diabetes mellitus
Endarterectomy, carotid
Perioperative period
