摘要
Abstract
[Objective]To investigate the effects of carotid endarterectomy(CEA)combined with coronary artery bypass grafting(CABG)on the treatment of coronary heart disease with carotid artery stenosis,cerebral hemodynamics,cognitive function and prognosis.[Methods]A total of 104 patients diagnosed with coronary heart disease combined with carotid artery stenosis in our hospital from December 2020 to December 2022 were selected.According to the different surgical intervention methods,a simultaneous operation group and a staged operation group were established,with 52 cases in each group.The intraoperative and postoperative related indicators were compared between the two groups,including operation time,single carotid artery occlusion time,graft blood flow,ICU stay time,and hospital stay time.The peak systolic velocity(PSV),resistance index of the middle cerebral artery(MCA),stenosis diameter,PSV,pulsatility index and cerebrovascular reactivity(CVR)of internal carotid artery on the affected side were compared between the two groups before operation and 1,3,and 6 months after operation.The quality of life(ADL)and cognitive function(MMSE)were compared between the two groups before operation and 1,3 and 6 months after operation.The incidence of complications within 6 months after operation was compared between the two groups.[Results]The operation time of the concurrent operation group was significantly higher than that of the staging operation group,and the ICU stay time and hospital stay of the concurrent operation group decreased significantly than those of the staging operation group(all P＜0.05).The cerebral hemodynamics indexes of the two groups at 1,3 and 6 months after surgery were significantly different from those before surgery(P＜0.05),and the MCA-PSV of the concurrent operation group at 1 and 3 months after surgery increased significantly than that of the staging operation group(P＜0.05).At 1,3 and 6 months after surgery,ADL scores in both groups decreased significantly than before surgery,and MMSE scores in both groups increased significantly than before surgery(all P＜0.05).The total complication rate of concurrent operation group decreased significantly than that of staging operation group(P＜0.05).[Conclusion]CEA combined with CABG therapy in patients with coronary heart disease combined with carotid artery stenosis has good clinical effect,good safety,and can also promote rapid recovery of patients.However,the operative time is longer,so it is necessary to pay specific attention to patients'surgical indications.关键词
颈动脉内膜剥脱术/冠状动脉旁路移植术/冠心病/颈动脉狭窄/血流动力学/认知功能/预后Key words
carotid endarterectomy/coronary artery bypass grafting/coronary heart disease/carotid artery stenosis/hemodynamics/cognitive function/prognosis分类
医药卫生
