摘要
目的比较颈动脉内膜切除术(CEA)和颈动脉支架成形术(CAS)治疗颈内动脉狭窄的安全性和有效性。方法回顾性分析2017年7月至2018年12月于苏州大学附属第一医院行手术治疗单纯颈内动脉狭窄的136例患者的临床资料。其中78例于神经外科接受CEA(CEA组),58例于介入科接受CAS(CAS组)。比较两组患者的一般资料、手术时长、术后并发症、术后住院时长、住院费用以及术后再狭窄的发生率。结果两组的年龄、性别、病变侧别、有无临床症状、术前合并症、术前颈内动脉狭窄率的差异均无统计学意义(均P>0.05)。两组患者在手术时长、术后并发症以及术后再狭窄的发生率上的差异均无统计学意义(均P>0.05)。136例患者的随访时间为3~21个月。CEA组的术后住院时长短于CAS组[分别为(6.5±2.3)d和(8.3±1.4)d,P<0.01],且住院费用低于CAS组[分别为(5.7±1.0)万元和(10.3±1.8)万元,P<0.01]。结论对于单纯颈内动脉狭窄患者,CEA和CAS两种术式均安全、有效;考虑到住院时间和经济因素,CEA具有一定的优势。
Objective To investigate the safety and efficacy of carotid endarterectomy(CEA)and carotid artery stenting(CAS)for the treatment of internal carotid artery stenosis.Methods This study retrospectively analyzed 136 patients who underwent surgical treatment of internal carotid artery stenosis at the First Affiliated Hospital of Soochow University from July 2017 to December 2018.Among those,78 underwent CEA(CEA group)at Department of Neurosurgery and the other 58 underwent CAS(CAS group)at Department of Interventional Radiology.General data,time of surgery,postoperative complications,postoperative hospital stay,hospitalization cost,and incidence of postoperative restenosis were compared between the 2 groups.Results There was no difference in the age,gender,lesion side,preoperative comorbidity,preoperative complication or preoperative internal carotid artery stenosis rate between 2 groups(all P>0.05).There was no significant difference in operation time,postoperative complications or the incidence of postoperative restenosis between 2 groups(all P>0.05).The follow-up period was 3 to 21 months.The postoperative hospital stay in CEA group was shorter than that in CAS group(6.5±2.3 d vs.8.3±1.4 d,P<0.01),and the hospitalization cost in CEA group was lower than that in CAS group(57±10 thousand yuans vs.103±18 thousand yuans,P<0.01).Conclusions For patients with internal carotid artery stenosis,both CEA and CAS seem safe and effective.In terms of hospital length-of-stay and economic factors,CEA has certain advantages over CAS.
作者
徐建国
陆小军
黄亚波
李波
刘一之
陈罡
Xu Jianguo;Lu Xiaojun;Huang Yabo;Li Bo;Liu Yizhi;Chen Gang(Department of Neurosurgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Neurosurgery,Taicang People's Hospital,Taicang 215400,China;Department of Interventional Radiology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2019年第11期1112-1116,共5页
Chinese Journal of Neurosurgery
基金
江苏省自然科学基金(BK20170371)
江苏省社会发展项目-临床前沿技术(BE2017656)。
