颈动脉内膜切除术后的急性脑血管事件

L. R. Akhmadeeva, V. V. Plechev, K. R. Izhbuldina, R. R. Gizatullin, M. O. Isrofilov
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摘要

介绍。急性脑血管意外是脑血管病(CVD)结构中公认的主要病理。全世界每年登记的心血管疾病病例达600万例。俄罗斯由这种病理导致的致命结果的发生率是发达国家的1.5-2倍。根据全俄预防医学中心的数据,25%的男性和39%的女性死于心血管疾病。俄罗斯的心血管疾病发病率为每10万人460至560例。这种病理可能是由动脉粥样硬化性血管病变和斑块形成导致的颈动脉狭窄引起的,从而导致栓塞和中风。材料和方法。该研究分析了2022年在巴什基尔国立医科大学诊所(BSMU Clinic)住院的341例颈动脉内膜切除术(CEE)患者的病史(其中288例有慢性脑血管意外病史)和2022年在阿维森纳塔吉克国立医科大学神经内科诊所住院的278例急性脑血管意外患者的病史。结果和讨论。2022年BSMU诊所CEE围手术期并发症包括缺血性急性脑血管意外12例(3.52%),短暂性脑缺血发作2例(0.6%),低于既往发表的同一诊所观察结果。结论。中东欧造成的并发症数量没有超过全球发生率。颈动脉重建的定量和定性指标显示出积极的趋势。急性脑血管意外需要明确其发生的原因,采取预防缺血性脑卒中的措施,包括血管外科干预。
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Acute Cerebral Vascular Events after Carotid Endarterectomy
Introduction . Acute cerebrovascular accident is recognized as the leading pathology in the structure of cerebrovascular diseases (CVD). Annually 6 million cases of CVD are registered in the world. Fatal outcomes from this pathology in Russia occur 1.5–2 times more often than in developed countries. According to the All-Russian Center for Preventive Medicine, 25% of males and 39% of females die from CVD. The incidence of CVD in Russia ranges from 460 to 560 cases per 100 thousand people. This pathology may be caused by carotid artery stenosis resulting from atherosclerotic vascular lesions and plaque formation which lead to embolism and stroke. Materials and methods . The study analyzed 341 medical histories of patients hospitalized at the Bashkir State Medical University Clinic (BSMU Clinic) in 2022, who underwent carotid endarterectomy (CEE) (288 of them had a history of chronic cerebrovascular accident) and 278 medical histories of patients with acute cerebrovascular accident, hospitalized at the Neurologic Clinic of the Avicenna Tajik State Medical University in 2022. Results and discussion . Perioperative complications that occurred during CEE at BSMU Clinic in 2022 included 12 cases of acute cerebrovascular accident of ischemic type (3.52%) and 2 cases of transient ischemic attack (0.6%), which is lower than the same rates in previously published observations at the same clinic. Conclusion . The number of complications resulting from the CEE does not exceed the global rates. Quantitative and qualitative indicators of carotid reconstructions demonstrate positive trends. Acute cerebrovascular accident requires clarifying the cause of its occurrence and taking measures to prevent ischemic strokes, including angiosurgical interventions.
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