[对前和后两分叉方法的比较:一项前性随机研究]
A V Maksimov1,2,3, R M Mullakhmetov1, R M Nuretdinov1
1Republican Clinical Hospital, Ministry of Health of the Republic of Tatarstan, 420138, Kazan, Russian Federation.
概括
关节内关节切除术的逆关节方法在预防神经复杂症或减少手术时间方面,与前关节方法相比,没有显著的优势. 这两种方法在中风预防手术中都显示出类似的安全性.
科学领域:
- 血管外科 血管外科
- 神经学 神经学
- 手术技巧 手术技巧
背景情况:
- Carotid Endarterectomy 是一种主要的中风预防程序.
- 标准化动脉分叉剖析技术仍然是一个挑战.
- 现有数据表明,前和后方法之间的安全性和疗效可能存在差异.
研究的目的:
- 为了前性地比较前性与后性方法的安全性和有效性,用于动脉分叉剖析.
- 评估并发症率,包括局部神经学缺陷和伤口并发症.
主要方法:
- 一项前性随机研究,涉及280名内动脉狭窄的患者.
- 患者被随机分配到后 (n=140) 或前 (n=140) 方法组.
- 关键的结果包括外科手术期间的中风,短暂的缺血性发作,血瘤和神经损伤.
主要成果:
- 在这两种方法之间,在外科手术期间大脑循环障碍,过渡性缺血性发作或血液瘤的发生率上没有发现显著差异.
- 局部神经症状,如发声障碍和声麻痺,在三个月内在所有患者中表现出相似的频率和完全回归.
- 在前 (76.1分钟) 和后 (74.2分钟) 两种方法中,手术持续时间相似.
结论:
- 虽然后关节的方法促进了动脉暴露,但与前关节的方法相比,它在局部神经复杂症或手术时间方面没有提供更好的结果.
- 这两种手术技术在动脉内关节切除术中都显示出相似的安全性.
- 在前和后方法之间的选择应基于外科医生的偏好和个体患者的解剖学.
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