Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2015, Vol. 15 ›› Issue (4): 296-301. doi: 10.3969/j.issn.1672-6731.2015.04.009

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Clinical analysis on the early complications after carotid endarterectomy

BU Mao-zhen1, YIN Guo-yang2, ZHANG Li-yong2, ZHANG Shi-gang2, WANG Ji-yue2   

  1. 1Department of Neurology, Yanggu Xian People's Hospital, Liaocheng 252300, Shandong, China
    2Department of Neurosurgery, Liaocheng People's Hospital, Liaocheng 252000, Shandong, China
  • Online:2015-04-25 Published:2015-04-21
  • Contact: WANG Ji-yue (Email: 13346256936@163.com)

颈动脉内膜切除术后早期安全性分析

布茂振, 尹国阳, 张利勇, 张士刚, 王继跃   

  1. 252300 山东省聊城市阳谷县人民医院神经内科(布茂振);252000 山东省聊城市人民医院神经外科(尹国阳,张利勇,张士刚,王继跃)
  • 通讯作者: 王继跃(Email:13346256936@163.com)

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

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