颅外段颈动脉支架植入术质量评价指标体系中国专家共识
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1.国家外周血管介入技术医疗质量控制中心专家委员会颈动脉疾病专家工作组;2.中国医学科学院阜外医院;3.复旦大学附属中山医院

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中国医学科学院医学与健康科技创新工程基金资助项目(2025-I2M-C&T-C-006)。


Chinese expert consensus on quality evaluation index system for extracranial carotid artery stenting
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    摘要:

    近年来,我国颅外段颈动脉支架植入术(CAS)手术规模持续扩大。如何建立科学的质量评价体系、优化手术规范流程,切实提升颈动脉狭窄闭塞性疾病患者的生存质量,已成为当前血管外科领域亟待解决的重要课题。经国家外周血管介入技术医疗质量控制中心专家委员会颈动脉疾病专家工作组全体专家讨论,拟定了风险校正术后30 d死亡率、术后非康复离院率、术后住院期间卒中/短暂性脑缺血发作发生率、术后30 d内非计划颈动脉再次干预发生率、术后急性冠脉综合征发生率、术后急性肾损伤发生率、术后入路血管再次干预发生率七项安全性指标,术前、术后抗血小板药物使用率,术前颈动脉狭窄程度评估率、颅内血管评估率、冠状动脉评估率,术中脑保护装置使用率五项技术性指标,以期通过上述关键质量指标的推广,提高不同地域、不同级别医疗机构CAS手术质量的均一性。

    Abstract:

    In recent years, the scale of extracranial carotid artery stenting (CAS) procedures in China has continued to expand. Establishing a scientific quality evaluation system, optimizing standardized surgical workflows, and effectively improving the survival quality of patients with carotid stenosis and occlusive diseases have become urgent challenges in the field of vascular surgery. After thorough discussions by the Expert Working Group on Carotid Artery Diseases of Expert Committee of the National Center for Medical Quality Control in Peripheral Vascular Interventional Technology, seven safety indicators were proposed: risk-adjusted 30-day postoperative mortality, risk-adjusted non-rehabilitative discharge rate, risk-adjusted in-hospital stroke/transient ischemic attack incidence, risk-adjusted 30-day unplanned carotid reintervention rate, risk-adjusted postoperative acute coronary syndrome incidence, risk-adjusted acute kidney injury incidence, and risk-adjusted access vessel reintervention rate. In addition, five technical indicators were established: pre- and postoperative antiplatelet medication use rate, preoperative carotid stenosis assessment rate, preoperative intracranial vascular evaluation rate, preoperative coronary artery assessment rate, and intraoperative cerebral protection device utilization rate. The promotion of these key quality indicators is expected to enhance the consistency of CAS surgical quality across medical institutions of different levels and regions.

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国家外周血管介入技术医疗质量控制中心专家委员会颈动脉疾病专家工作组,舒畅,符伟国.颅外段颈动脉支架植入术质量评价指标体系中国专家共识[J].中国普通外科杂志,,().
DOI:10.7659/j. issn.1005-6947.250465

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  • 收稿日期:2025-08-20
  • 最后修改日期:2025-08-20
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  • 在线发布日期: 2025-09-30