發(fā)布時(shí)間：2019-04-23 21:08

【摘要】：頸動(dòng)脈內(nèi)膜切除術(shù)(CEA)是治療頸動(dòng)脈狹窄、預(yù)防腦卒中的"金標(biāo)準(zhǔn)",國(guó)外已相對(duì)成熟,國(guó)內(nèi)雖起步晚,但發(fā)展迅速。筆者在CEA的推廣過(guò)程中,發(fā)現(xiàn)很多同道雖然可基本掌握手術(shù)技巧,但在概念理解、術(shù)式選擇、技術(shù)理念、并發(fā)癥防治等方面與國(guó)際先進(jìn)水平仍存差距。很多同道在實(shí)際工作中仍在糾結(jié)于以下問(wèn)題:CEA是切斑塊還是切內(nèi)膜?如何切除?切除的部位?切除到何種程度?是否需加做血管裁剪和吻合口成形?本文針對(duì)CEA在"真實(shí)世界"中的四則爭(zhēng)議——概念存疑、術(shù)式糾結(jié)、理念差異和技術(shù)困惑——進(jìn)行概括并提出個(gè)人思考,同時(shí)與各位讀者分享本領(lǐng)域的最新進(jìn)展。
[Abstract]:Carotid endarterectomy (CEA) is a "golden standard" for the treatment of carotid stenosis and the prevention of stroke. It has been relatively mature abroad. Although it started late at home, it has developed rapidly. In the process of popularizing CEA, it is found that although many of them can master basic surgical techniques, there is still a gap between them in terms of understanding of concepts, choice of surgical procedures, technical concepts, prevention and treatment of complications and so on. Many colleagues are still struggling with the following questions in practical work: is CEA cutting plaques or endomembranes? How? The excised part? To what extent? Is there a need for vascular clipping and anastomosis? In this paper, four controversies of CEA in the "real world"-doubt of concept, entanglement of operation, difference of concept and technical confusion-are summarized and personal thinking is put forward. At the same time, the latest progress in this field is shared with readers.
【作者單位】： 第二軍醫(yī)大學(xué)長(zhǎng)征醫(yī)院血管外科;
【基金】：上海高校特聘教授(東方學(xué)者)跟蹤計(jì)劃基金(GZ2016008) 上海領(lǐng)軍人才基金(035) 國(guó)家自然科學(xué)基金(81570440) 上海市科委2016年度醫(yī)學(xué)引導(dǎo)類(lèi)(中、西醫(yī))科技支撐項(xiàng)目基金(16411966500)~~
【分類(lèi)號(hào)】：R651.12

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本文編號(hào)：2463800