中国普通外科杂志2017，Vol.26Issue(6)：711-716,6.DOI:10.3978/j.issn.1005-6947.2017.06.007
同期颈动脉支架术及冠状动脉旁路移植术治疗颈动脉狭窄合并冠心病的疗效分析
Efficacy of simultaneous carotid artery stenting and coronary artery bypass grafting for carotid stenosis and concomitant coronary disease
摘要
Abstract
Objective:To evaluate the efficacy of simultaneous carotid artery stenting (CAS) and coronary artery bypass grafting (CABG) in treatment of carotid stenosis and concomitant coronary disease.Methods:The clinical data of 25 patients with carotid stenosis and concomitant coronary disease treated in China-Japan Friendship Hospital from January 2007 to December 2014 were retrospectively analyzed.of the patients,11 cases underwent simultaneous CAS and CABG (one-stage group),and 14 cases underwent staged CAS and CABG (two-stage group).The main clinical variables between the two groups of patients were compared.Results:T-he preoperative general data were comparable between the two groups.In one-stage group compared with two-stage group,the median operative time (250 min vs.280 min) and median length of hospital stay (19 d vs.24 d) were significantly reduced (both P＜0.05),while the median intraoperative blood loss (750 mL vs.600 mL),blood infusion (1 000 mL vs.1 200 mL),length ofICU stay (23 h vs.24 h) and time on ventilator (19 h vs.16.5 h) all showed no statistical difference (all P＞0.05).Minor stroke within 30 d after operation,transient ischemia attack and perioperative pulmonary infection occurred in one case each and transient postoperative hypotension occurred in 3 cases in one-stage group;TIA occurred in one case,transient postoperative hypotension occurred in 4 cases,rethoracotomy for hemostasis was required in one case and perioperative pulmonary infection occurred in one case in two-stage group.No myocardial infarction or death occurred in either of the groups.Conclusion:Both simultaneous and staged CAS and CABG are safe and reliable in treatment of carotid stenosis concomitant with coronary disease,and the simultaneous procedure can reduce operative time and hospitalization.However,the appropriate treatment method should be chosen according to the patients' characteristics.关键词
颈动脉狭窄/冠心病/支架/冠状动脉分流术Key words
Carotid Stenosis/Coronary Disease/Stents/Coronary Artery Bypass分类
医药卫生引用本文复制引用
张建彬,叶志东,刘鹏,樊雪强,郑夏,陈洁,马博,孔杰,崔艺耀,王峰,聂强强..同期颈动脉支架术及冠状动脉旁路移植术治疗颈动脉狭窄合并冠心病的疗效分析[J].中国普通外科杂志,2017,26(6):711-716,6.基金项目
中日友好医院院级科研基金资助项目(2014-1-QN-1). （2014-1-QN-1）
