| 摘要: |
| 目的 该研究通过对照性研究旨在探讨超声引导颈动脉窦阻滞在颈动脉支架成形术（Carotid Artery Stenting, CAS）中的应用价值。方法 采用前瞻性随机对照研究方法，选择2017年1月-2019年6月我院拟行CAS的颈内动脉狭窄患者共145例，使用随机数字表法将患者随机分为两组：A组（73例）术前在超声引导下常规行患侧颈动脉窦阻滞，B组（72例）术前不做处理。观察A组患者颈动脉窦阻滞过程中有无不良反应，并记录阻滞时间、麻醉药物用量。监测并比较两组患者术中发生心动过缓、低血压、心脏骤停及术后发生脑卒中事件例数。结果 两组患者一般资料具有可比性（P＞0.05）。A组术中低血压、心动过缓人数比例分别为4/73、12/73，均小于B组的16/72、35/72，差异均具有统计学意义（P＜0.05）。A组围手术期无心脏停搏和脑卒中事件发生，B组术中发生1例心脏停搏，术后出现3例脑卒中事件。A患者围手术期心脏停搏和脑卒中事件总发生率低于B组（5.56%），差异有统计学意义（P＜0.05）。A组患者在颈动脉窦阻滞过程中出现1例患侧上眼睑下垂，经休息后好转。两组患者均顺利完成手术。结论 术前在超声引导下行患侧颈动脉窦阻滞可减少术中低血流动力学改变事件的发生，该技术操作简便，总体安全可行，值得临床进一步推广应用。 |
| 关键词: 颈动脉窦阻滞 颈动脉狭窄 颈动脉支架成形术 低血流动力学改变。 |
| DOI： |
| 投稿时间：2020-03-20修订日期：2020-09-14 |
| 基金项目: |
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| Application value of ultrasound-guided carotid sinus nerve block in carotid artery stenting |
| liu qing hua,liu xue ping,cheng guo bing,lu wei |
| () |
| Abstract: |
| Objective The purpose of this study was to investigate the value of ultrasound-guided carotid sinus block in carotid stenting(CAS)．Method A prospective single—center randomized controlled study was conducted on 145 patients with intemal carotid artery stenosis receiving CAS from January 2017 to June 2019．Patients were randomly divided into group A (n=73)treated with local anesthesia of the carotid artery sinus guided by ultrasound preoperatively and group B(n=72) without local anesthesia．To observe whether there were adverse reactions during carotid sinus nerve block and record the block time and anesthesia dose in group A.The incidence of bradycardia, hypotension and stroke were monitored and compared between the two groups.Results The preoperative general data of the two groups were comparable (P > 0.05)．The proportion of patients with intraoperative hypotension and bradycardia in group A was 4/73 and 12/73, respectively, which were all lower than 16/72 and 35/72 in group B, (P < 0.05).In group A, no cardiac arrest or stroke occurred during perioperative period, while in group B, 1 cardiac arrest occurred during the operation and 3 stroke events occurred after the operation，The total incidence of perioperative cardiac arrest and stroke in patients A was lower than that in group B (5.56%)(P < 0.05).There was 1 case of droop of upper eyelid of the affected side during carotid sinus nerve block in group A, and the patient recovered after restt.The two groups of patients allsuccessfully completed the operation.Conclusion Preoperative ultrasound-guided carotid sinus nerve block on the affected side can reduce the occurrence of intraoperative hemodynamic instability. This technique is workable, safe and feasible, and worthy of further clinical application. |
| Key words: Carotid sinus block Carotid artery stenosis Carotid artery stenting hemodynamic instability. |
