颈动脉内膜剥脱术后血流动力学不稳定危险因素研究及对预后的影响

doi:10.3969/j.issn.2095-378X.2026.01.002

摘要/Abstract

摘要： 目的探讨颈动脉内膜剥脱术（CEA）后血流动力学不稳定（HI）危险因素及HI对预后的影响。方法收集2015年1月—2020年12月在复旦大学附属华山医院行CEA的363例患者资料,根据CEA术后是否出现HI分为正常组（n=291）和HI组（n=72）。采用logistic回归模型分析CEA术后发生HI的危险因素。结果单因素和多因素分析显示,短暂性脑缺血发作（TIA）是CEA后HI的独立危险因素。两组患者在近期心肌梗死发生率、远期全因死亡率、心脑血管死亡率及血压控制方面具有统计学差异（P<0.05）。结论 TIA是CEA术后HI发生的独立危险因素;HI可增加术后30 d内心肌梗死发生率以及术后5年内心脑血管死亡率、全因死亡率,增加远期血压控制难度。

关键词: 颈动脉内膜剥脱术, 血流动力学不稳定, 危险因素, 预后

Abstract: Objective To explore the risk factors for hemodynamic instability （HI） after carotid endarterectomy （CEA） and its impact on prognosis. Methods Data from 363 patients who underwent CEA at Huashan Hospital, Fudan University between January 2015 and December 2020 were collected. Based on the occurrence of HI after CEA, the patients were divided into a control group （n=291） and an HI group （n=72）. Logistic regression models were used to analyze the risk factors for HI following CEA. Results Univariate analysis and multiple analysis showed that transient ischemic attack （TIA） was an independent risk factor for HI after CEA. Statistically significant differences （P<0.05） were observed between the two groups in terms of the incidence of short-term myocardial infarction, long-term all-cause mortality, cardio-cerebrovascular mortality, and blood pressure control. Conclusion TIA is an independent risk factor for HI after CEA. HI increases the incidence of myocardial infarction within 30 d after surgery, as well as cardio-cerebrovascular mortality and all-cause mortality within 5 years after surgery, making long-term blood pressure control more challenging.

Key words: Carotid endarterectomy, Hemodynamic instability, Risk factors, Prognosis

中图分类号:

R651.12

周林, 范伟健, 谭晋韵. 颈动脉内膜剥脱术后血流动力学不稳定危险因素研究及对预后的影响[J]. 外科研究与新技术（中英文）, 2026, 15(1): 6-9.

ZHOU Lin, FAN Weijian, TAN Jinyun. Risk factors for hemodynamic instability after carotid endarterectomy and its impact on prognosis[J]. Surgical Research and New Technique, 2026, 15(1): 6-9.

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