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[Clinical analysis on monitoring and comprehensive treatment after carotid endarterectomy].
Zhonghua Yi Xue za Zhi [Chinese medical journal] 2017 May 31
Objective: To discuss the therapeutic effect of management of carotid endarterectomy in care unit. Methods: A total of 315 patients with carotid atherosclerotic stenosis were enrolled. All of the patients were taken into care unit under tracheal intubation anesthesia after carotid endarterectomy. Then the patients were managed with a breathing machine, continuous sedation, strict monitoring of hemodynamics and pupil change, strict control of heart rate and blood pressure, atomization inhalation therapy, treatment of anticoagulation and antiplatelet therapy and classification management of airway. Results: All patients were recovered well and no death was documented, among which cranial nerve injury occurred in 2 cases, incision bleeding was observed in 6 patients, endotracheal intubation were performed again in 4 cases due to postoperative airway obstruction, pneumonia was found in 2 cases, aphasia and homolateral hemiplegia were observed in one case, while disturbance of consciousness and contralateral hemiplegia occurred in 1 case, psychiatric symptoms occurred temporarily after operation in 8 cases, and one case suffered from acute myocardial infarction. Conclusion: The present study suggests that the comprehensive measures, including continuous sedation, strict control of heart rate and blood pressure, classification management of airway and so on, can be beneficial to postoperative anesthesia recovery and ideal blood pressure, and prevent the occurrence of cerebral hyperperfusion syndrome effectively.
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