颈动脉内膜切除术的发展与研究进展

Development and Research Advances in Carotid Endarterectomy

摘要: 脑卒中是我国乃至全世界中老年人致死、致残的重要病因，其中缺血性脑卒中占比较高，严重危害了生命健康和社会经济。缺血性脑卒中常由颈动脉粥样硬化性狭窄引起，颈动脉内膜切除术(Carotid Endarterectomy, CEA)作为一种治疗颈动脉狭窄的重要外科手术，在降低颈动脉狭窄患者脑卒中发生率及改善预后方面发挥了关键作用。近年来，随着相关研究的深入，CEA在适应症选择、手术技术改进、术后护理以及长期疗效监测等多个方面均取得了显著进展。如今，CEA相关手术技术的不断创新使其在安全性与有效性方面持续提升，其适应症已经从单纯针对高危患者扩展至部分低危患者。然而，虽已有大量研究探讨了CEA的疗效和风险，但关于手术适应症、并发症管理及术后随访等方面仍存在许多争议。本文旨在系统回顾CEA的发展历程，分析当前研究进展，探讨现阶段面临的问题，展望未来研究方向，以期为临床实践及相关学术研究提供有价值的参考。

Abstract: Stroke is a leading cause of death and disability among middle-aged and elderly individuals in China and worldwide, with ischemic stroke accounting for a significant proportion, posing severe threats to both life health and socioeconomic well-being. Ischemic stroke is often caused by carotid atherosclerotic stenosis, and carotid endarterectomy (CEA), as a critical surgical intervention for treating carotid stenosis, plays a pivotal role in reducing stroke incidence and improving prognosis in affected patients. In recent years, with in-depth research, significant progress has been made in various aspects of CEA, including patient selection, surgical technique refinement, postoperative care, and long-term efficacy monitoring. Today, continuous innovations in CEA-related surgical techniques have further enhanced its safety and efficacy, expanding its indications from high-risk patients alone to include certain low-risk cases. However, despite extensive studies on the outcomes and risks of CEA, many controversies remain regarding surgical indications, complication management, and postoperative follow-up. This article systematically reviews the historical development of CEA, analyzes current research advancements, discusses existing challenges, and explores future research directions, aiming to provide valuable insights for clinical practice and related academic studies.