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中华脑血管病杂志(电子版) ›› 2024, Vol. 18 ›› Issue (03) : 210 -214. doi: 10.11817/j.issn.1673-9248.2024.03.003

论著

是否留置术区引流管对颈动脉内膜切除术围手术期安全性的影响
张顺1, 杨希孟1, 陆军1, 王海峰1, 张东1,()   
  1. 1. 100730 北京医院神经外科 国家老年医学中心 中国医学科学院老年医学研究院
  • 收稿日期:2024-04-17 出版日期:2024-06-01
  • 通信作者: 张东
  • 基金资助:
    北京医院临床研究“助航”专项(BJ-2022-122); 北京医院临床研究“启航”专项(BJ-2022-168)

Impact of drains placement on perioperative safety in carotid endarterectomy

Shun Zhang1, Ximeng Yang1, Jun Lu1, Haifeng Wang1, Dong Zhang1,()   

  1. 1. Department of Neurosurgery, Bejing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2024-04-17 Published:2024-06-01
  • Corresponding author: Dong Zhang
引用本文:

张顺, 杨希孟, 陆军, 王海峰, 张东. 是否留置术区引流管对颈动脉内膜切除术围手术期安全性的影响[J/OL]. 中华脑血管病杂志(电子版), 2024, 18(03): 210-214.

Shun Zhang, Ximeng Yang, Jun Lu, Haifeng Wang, Dong Zhang. Impact of drains placement on perioperative safety in carotid endarterectomy[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(03): 210-214.

目的

分析颈动脉内膜切除术(CEA)后是否留置引流管对围手术期安全性的影响。

方法

回顾性分析北京医院神经外科2019年2月至2024年2月行CEA手术患者的临床资料。根据术后是否留置术区引流管将其分为无引流组及引流组。应用t检验及χ2检验比较2组之间手术后住院时间、术后血肿发生率、需手术干预血肿发生率、围手术期死亡率以及切口感染、急性心肌梗死、手术相关脑梗死、颅神经损伤、手术相关脑出血等围手术期并发症的发生率。

结果

无引流组患者66例,行CEA手术73次;引流组患者66例,行CEA手术68次。无引流组与引流组术后血肿发生率、需手术干预血肿发生率、围手术期死亡率以及其他围手术期并发症发生率比较,差异均无统计学意义(P均>0.05),无引流组病例术后出院时间较引流组患者缩短[(4.48±2.49)d vs(5.67±3.42)d],差异具有统计学意义(t=-2.272,P=0.025)。

结论

无引流CEA手术围手术期并发症发生率与留置引流管CEA手术无显著差异,同时术后不留置引流管可以缩短患者术后住院时间。

Objective

To evealuate the impact of postoperative drain placement on the perioperative safety outcomes in patients undergoing carotid endarterectomy (CEA).

Methods

We retrospectively analyzed 141 CEA procedures performed at the Neurosurgery Department of Beijing Hospital between February 2019 and February 2024. The patients were categorized into two group: the non-drainage group and the drainage group, based on the use of a drain. Outcomes were compared between the two groups, including the duration of postoperative hospitalization, incidence of postoperative hematoma, frequency of hematomas requiring surgical intervention, perioperative mortality, and the occurrence of wound infection, acute myocardial infarction, surgery-related stroke, cranial nerve impairment, and cerebral hemorrhage associated with the surgery. T-test and chi-square were performed.

Results

In the non-drainage group, 66 patients underwent CEA surgery 73 times. In the drainage group, 66 patients underwent CEA surgery 68 times.The analysis revealed no marked variance between the groups in terms of postoperatively drain placement and the incidence of postoperative hematoma, the rate of hematomas requiring further surgical measures, perioperative mortality, or any other complications (all P>0.05). However, the duration of postoperative hospital stay showed a statistically significant decrease in the group without drain placement compared to their counterparts [(4.48±2.49) d vs (5.67±3.42)d, t=-2.272, P=0.025].

Conclusion

The incidence of perioperative complications following CEA was not significantly different between the patients who received drain placement and those who did not. Furthermore, the absence of drain placement was associated with a shorter hospital stay duration.

表1 无引流组及引流组接受颈动脉内膜切除术患者一般临床资料比较
临床资料 无引流组(n=66) 引流组(n=66) 统计值 P
年龄(岁,
x¯±s
66.03±7.58 65.26±9.00 t=0.533 0.595
性别[例(%)] χ2=0.444 0.505
52(78.8) 55(83.3)
14(21.2) 11(16.7)
高血压[例(%)] χ2=1.257 0.262
48(72.7) 42(63.6)
18(27.3) 24(36.4)
糖尿病[例(%)] χ2=0.133 0.715
24(36.4) 22(33.3)
42(63.6) 44(66.7)
高脂血症[例(%)] χ2=1.054 0.305
13(19.7) 18(27.3)
53(80.3) 48(72.7)
冠心病[例(%)] χ2=0.398 0.528
16(24.2) 13(19.7)
50(75.8) 53(80.3)
吸烟史[例(%)] χ2=1.941 0.164
28(42.4) 36(54.5)
38(57.6) 30(45.5)
饮酒史[例(%)] χ2=4.569 0.033
20(30.3) 32(48.5)
46(69.7) 34(51.5)
脑血管病家族史[例(%)] χ2=9.101 0.003
2(3.0) 13(19.7)
64(97.0) 53(80.3)
侧别[例(%)] χ2=0.888 0.346
右侧 38(52.1) 30(44.1)
左侧 35(47.9) 38(55.9)
合并对侧颈动脉狭窄[例(%)] χ2=2.644 0.104
13(17.8) 20(29.4)
60(82.2) 48(70.6)
临床症状[例(%)] χ2=6.581 0.010
无症状 27(37.0) 12(17.6)
有症状 46(63.0) 56(82.4)
颈动脉阻断时长(min,
x¯±s
28.04±8.10 30.39±9.19 t=-1.592 0.114
围手术期抗血小板/抗凝药物使用[例(%)] χ2=3.341 0.188
阿司匹林 41(56.2) 33(48.5)
阿司匹林+氯吡格雷 20(27.4) 28(41.2)
其他 12(16.4) 7(10.3)
表2 无引流组及有引流组接受颈动脉内膜切除术患者主要围手术期并发症比较
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