摘要： 目的 回顾分析颈动脉内膜切除术后早期并发症发生原因及其影响因素，以评价颈动脉内膜切除术后早期安全性。方法 396 例颈动脉狭窄患者共完成407 例次颈动脉内膜切除术，于术后30 d 评价手术疗效，单因素和多因素Logistic 回归分析评价术后30 d 内不良事件相关影响因素。结果 407 例次颈动脉内膜切除术成功率为100%，术后30 d 内主要并发症发生率4.42%（18/407）、次要并发症24.08%（98/407）。Logistic回归分析显示，仅吸烟（P = 0.039）和入院时改良Rankin 量表（mRS）评分≥3 分（P = 0.001）为颈动脉内膜切除术后早期（30 d 内）不良事件的独立危险因素。结论 颈动脉内膜切除术后并发症发生率较低、安全性较高，积累手术经验、提高手术技巧有助于减少术后并发症。吸烟和入院时mRS评分≥ 3分患者围手术期并发症发生率显著高于其他患者。

关键词: 颈动脉内膜切除术, 手术后并发症, 危险因素, 回归分析

Abstract: Objective  To analyze the influencing factors of early complications after carotid endarterectomy (CEA), in order to evaluate the early safety after CEA.  Methods  A total of 396 patients with carotid stenosis underwent 407 CEAs, and the complications within 30 d after CEA were analyzed. Univariate and backward multivariate Logistic regression analysis were used to evaluate the related risk factors for major adverse events within 30 d after CEA.  Results  The success rate of 407 CEAs was 100%. Major complications within 30 d after CEA occurred in 18 cases (4.42%), including 5 cases (1.23%) of death, 8 cases (1.97% ) of ischemic stroke and 5 cases (1.23% ) of cerebral hemorrhage. Secondary complications occurred in 98 cases (24.08%). Logistic regression analysis revealed smoking (P = 0.039) and modified Rankin Scale (mRS) score on admission ≥ 3 (P = 0.001) were the independent risk factors for early adverse events (within 30 d) after CEA.  Conclusions CEA is a safe surgical method with a low incidence rate of postoperative complications, which could be decreased by improving surgical skills and gathering surgical experiences. Smoking and mRS score on admission ≥ 3 can increase the risk of CEA.

Key words: Endarterectomy, carotid, Postoperative complications, Risk factors, Regression analysis