临床外科杂志 ›› 2020, Vol. 28 ›› Issue (12): 1119-1122.doi: 10.3969/j.issn.1005-6483.2020.12.007

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颈动脉重度狭窄内膜剥脱术与血压变化之间的相关性分析

  

  1. 261053 山东潍坊医学院(代领);山东省济宁医学院附属日照市人民医院神经外科(张玉海、曹军、胡庆雷、柏明涛);山东第一医科大学附属日照市中医医院神经外科(丁伟)
  • 出版日期:2020-12-20 发布日期:2020-12-20
  • 通讯作者: 丁伟,Email:dwrz001@sohu.com

The study on the correlation between blood pressure changes after Carotid endarterectomy in patients with severe carotid stenosis

  1. Department of Neurosurgery,the People's Hospital of Rizhao,Shandong,Rizhao 261053,China
  • Online:2020-12-20 Published:2020-12-20

摘要: 目的 探讨颈动脉内膜剥脱术(CEA)与重度颈动脉狭窄病人血压变化之间的相关性。
方法 行CEA的重度颈动脉狭窄高血压病人60例为实验组;未行CEA,行保守治疗的重度颈动脉狭窄高血压病人20例为对照组。两组经数字减影血管造影(DSA)证实存在单侧颈动脉单处重度狭窄且无其他高血压致病因素。根据颈动脉狭窄的程度,将实验组分为1组(20例,单侧颈动脉单处狭窄70%~79%)、2组(20例,单侧颈动脉单处狭窄80%~89%)、3组(20例,单侧颈动脉单处狭窄90%~99%);对照组为4组(20例,单侧颈动脉单处狭窄70%~99%)。测量4组术前1周、术后1周、术后1个月、术后6个月的血压,比较4组间血压变化。
结果 CEA术后,病人血压明显降低,血压下降幅度:3组>2组>1组(P1∶2<0.05;P2∶3<0.01;P1∶3<0.001)。
结论 CEA可以改善心功能,显著降低单侧颈动脉单处重度狭窄高血压病人的血压。血压下降幅度与颈动脉狭窄程度呈正相关,狭窄程度越重,血压下降幅度越大。

关键词: 颈动脉粥样硬化, 血压变化, 颈动脉内膜切除术, 重度颈动脉狭窄

Abstract: Objective To investigate the correlation between carotid endarterectomy(CEA) and blood pressure changes in patients with severe carotid stenosis.
Method 60 patients with severe carotid stenosis and hypertension who underwent CEA were selected as the experimental group;20 patients with severe carotid stenosis and hypertension who did not receive the CEA and receive conservative treatment were the control group.The DSA(digital subtraction angiography) confirmed the existence of unilateral carotid artery single severe stenosis and no other causes of hypertension.Based on the degree of carotid ar-tery stenosis,the experimental group was divided into the first group(70%~79% of unilateral carotid artery stenosis,n=20);the second group(80%~89% of unilateral carotid artery stenosis,n=20);the third group(90%~99% of unilateral carotid artery stenosis,n=20);the control group was the fourth group(70%~99% of unilateral carotid artery stenosis,n=20).Blood pressure was measured in 1 week before surgery,1 week after surgery,1 month after surgery,the 6 month after surgery in all four groups.Blood pressure changes were compared between the four groups.
Results  After the CEA,the blood pressure of the patients decreased significantly,the range of blood pressure decreased:the third group > the second group > the first group(P1∶2<0.05;P2∶3<0.01;P1∶3<0.001).
Conclusion CEA can significantly reduce the blood pressure in hypertensive patients with unilateral carotid artery single severe stenosis,the decrease of blood pressure is positively correlated with the degree of carotid artery stenosis,The more severe the degree of carotid stenosis,the greater the decrease of blood pressure.

Key words: carotid atherosclerosis, alternation of blood pressure, carotid endarterectomy, severe carotid stenosis

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