摘要
目的:比较分析静脉溶栓桥接支架取栓与单纯支架取栓对颅内大血管急性闭塞开通的安全性和有效性。方法:岳阳市一人民医院2016-01-2018-12治疗的29例急性颅内大血管闭塞患者,根据治疗方案的不同将其分为单纯支架取栓组(单纯取栓组,16例)和静脉溶栓桥接支架取栓组(桥接治疗组,13例)。通过改良脑梗死溶栓试验(mTICI)评估血管再通情况。统计分析两组平均血管开通时间、平均取栓次数、术后24h以及术后7天NIHSS评分和90天改良Rankin评分(mRS)、症状性出血及其它恶性并发症的发生情况。结果:两组患者经取栓治疗后血管开通情况良好,术后NIHSS评分改善无统计学差异(P>0.05)。桥接取栓组平均血管开通时间为(95.00±15.00)min,平均取栓次数为(3.10±0.90)次,术后并发症发生率为30.77%,90天mRS评分0-2分患者占61. 54%(8/13)。单纯取栓组平均血管开通时间为(98.00±17.00)min,平均取栓次数为(3.30±1.10)次;术后并发症发生率为31.25%,90天mRS评分0-2分患者占37. 50%(6/16)。以上两组指标相比,单纯支架取栓组与静脉溶栓桥接取栓组血管再通时间、取栓次数以及手术并发症均无明显统计学差异,但二组在90天mRS评分0-2分者所占比例差异具有统计学意义(P<0.05)。结论:静脉溶栓桥接支架取栓和单纯支架取栓均能快速开通颅内闭塞大动脉,但前者在改善患者临床预后方面优于后者。
Objective: To compare the safety and effectiveness between intravenous thrombolysis bridging stent mechanical thrombolysis and simple stent mechanical thrombolysis for the treatment of acute intracranical large-vessel occlusion.Method: The clinical data of 29 patients with acute intracranical large vessel occlusion treated with intravenous thrombolysis bridging stent mechanical thrombolysis and simple stent mechanical thrombolysis from January 2016 to December 2018 were analyzed.According to different treatment protocols, patients were divided into either a simple stent mechanical thrombectomy group(n=16) or intravenous thrombolysis bridging stent mechanical thrombolysis(n=13). Surgical results passed mTICI evaluation. The mTICI grade of above IIb is being as good recanaliazation.The vascular recanalization time, average number of thrombectomy, NIHSS scores on admission, at 24 h after procedure and at day 7, mRS at day 90 and postoperative complications treated with two kinds of intra-arterial treatment were calculated and analyzed.Results: After thrombolytic therapy, the recanalization of blood vessels in the two groups was good, and there was no statistically significant difference in the short-term NIHSS after procedure.The mean recanalization time of intravenous thrombolysis bridging stent mechanical thrombolysis group was(95.00±15.00) min and the mean number of arterial embolectomy was(3.10±0.90) times.The complication rate after procedure was 30.77%.The patients of mRS(0-2) accounted for 61.54%(8/13) at 90 days of follow-up.The mean recanalization time of stent mechanical thrombectomy group was(98.00±17.00) min and the mean number of arterial embolectomy was(3.30 ± 1.10) times.The complication rate after procedure was 31.25%.The patients of mRS(0-2) accounted for 37.50%(6/16) at 90 days of follow-up.In the above indices,there were significant differences between two groups in mRS at 90 days of follow-up(P<0.05),while there were no obvious difference between two groups of patients on recanalization time,
作者
周溱
周江
马艳
刘亚
华赞
许泽武
周元
颜剑平
ZHOU Zhen;ZHOU Jiang;MA Yan;LIU Ya;HUA Zan;XU Ze-wu;ZHOU Yuan;YAN Jian-ping(Department of Neurology, Yueyang No.1 People's Hospital, Yueyang 414000, China)
出处
《微循环学杂志》
2019年第2期24-27,32,共5页
Chinese Journal of Microcirculation
关键词
急性颅内大血管闭塞
静脉溶栓
支架取栓
静脉溶栓桥接支架取栓
Intracranical large artery occlusion
Intraveneous thrombolysis
Stent mechanicalthrombectomy
Intravenous thrombolysis bridging stent mechanical thrombectomy
