【正文】 術(shù)中解剖演示 第五十七頁，共六十一頁。 Residual clot is flushed away. 第四十七頁，共六十一頁。 especially at the bifurcation it runs some 3 mm lateral from the upper aspect of the bifurcation。 Arteria branch of the great auricular nerve。 ? 器械對縫合線的損傷隱患最大。 麻醉深度監(jiān)測 麻醉深度電極 腦氧監(jiān)測 第十一頁，共六十一頁。 國家遠(yuǎn)程卒中中心、腦防委 CEA培訓(xùn)基地、北京市腦血管病中心 第二頁，共六十一頁。 Conclusion: The two groups did not significantly differ for quality of life, length of hospital stay, or the primary oute in the prespecified subgroups of age, contralateral carotid occlusion, and baseline surgical risk. 兩個(gè)組在生活質(zhì)量、住院時(shí)間、預(yù)設(shè)不同年齡組的結(jié)果、雙側(cè)頸動(dòng)脈閉塞和手術(shù)風(fēng)險(xiǎn)等方面均無顯著差異。 顯微操作中器械 第二十二頁，共六十一頁。 第三十二頁，共六十一頁。 頸袢： Ansa cervicalis。 頸外動(dòng)脈斑塊處理： Atheromatous core extends into the external carotid artery, usually for 5–10 mm. Y型切開： 第四十五頁，共六十一頁。 HOW TO AVOID COMPLICATIONS ? PATIENT SELECTION ? ANAESTHESIA (gentle and smooth anaesthesia) ? MONITORING (諸多方面： BP，術(shù)中轉(zhuǎn)流的監(jiān)測，血管縫合后的即刻監(jiān)測，術(shù)后切口的觀察等 ) ? DISSECTION AND ENDARTERECTOMY ? CROSS CLAMPING 〔 Proper sequence of clip application and removal decreases the risk of perioperative embolisation.〕 ? HAEMOSTASIS 〔 meticulous haemostasis〕 ? HEPARIN NONREVERSAL ? POSTOPERATIVE CARE 第五十四頁，共六十一頁。 您的聆聽 第六十頁，共六十一頁。 IV. More knots are used – usually 7 – and the ends of the stitches are cut longer, some 5–6 mm from the knots. 第四十八頁，共六十一頁。 遠(yuǎn)端 : the arteriotomy on the anterolateral aspect of the internal carotid is taken beyond the severe disease, this being usually within 1–2 centimeters of its origin。 it is merely identifi ed and left untouched. 觸及 CCA，別離方向：向頭端，由 CCA, ICA, ECA, superior thyroid arteries； 向上： Posterior belly of the digastric muscle〔二腹肌〕 。 ? 肝素： Dose of 5000 units of heparin or 30 u/kg body weight of intravenous heparin。 術(shù)后麻醉與 TCCD定控制范圍 麻醉機(jī) 第十四頁，共六十一頁。 I. Supine position。 麻醉方式 ? 全麻： General anaesthesia has several advantages, including easier surgical manoeuvres, handling of plications and easier patient monitoring. ? 局麻： local/regional anaesthesia decreases the number of medical plicationsat the expense of neurological plications. 第八頁，共六十一頁。 顯微操作前器械 第十九頁，共六十一頁。 Modified Eversion Carotid Endarterectomy Ann Vasc Surg 2024。 肝素： Dose of 5000 units o