摘要
目的探讨使用直接抽吸首次通过技术(a direct aspiration first-pass technique,ADAPT)治疗急性大血管闭塞性卒中的安全性和有效性。方法回顾性分析12例采用ADAPT技术治疗急性大血管闭塞性卒中病人的临床资料。应用脑梗死溶栓(thrombolysis in cerebral infarction,TICI)分级评估闭塞血管再通情况,美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分评估病人的神经功能缺失情况。术后90 d进行随访,采用改良Rankin量表(modified Rankin Scale,mRS)评分评估病人的独立生活情况。结果本组平均使用ADAPT(2.0±1.8)次,发病至股动脉穿刺的平均间隔时间(360.8±170.9)min,股动脉穿刺至血管再通平均时间(133.1±43.2)min。术后即刻获得有效再通(TICI 2b~3级)11例,其中TICI 3级7例,2b级4例;TICI 2a级1例。手术前后NIHSS评分差异有统计学意义(P<0.05)。死亡2例。10例病人术后90 d随访mRS评分1分5例,3分2例,4分1例,5分2例。结论ADAPT技术治疗急性大血管闭塞性卒中安全、有效。
Objective To investigate the safety and efficacy of a direct aspiration first-pass technique(ADAPT)in the treatment of acute large vessel occlusion stroke.Methods Clinical data of 12 patients with acute large vessel occlusion stroke undergoing ADAPT were analyzed retrospectively.Thrombolysis in cerebral infarction(TICI)was used to assess the recanalization of occluded vessels,and the National Institute of Health Stroke Scale(NIHSS)score was used to assess the neurological deficit.The patients were followed up for 90 days after the operation,and the independent living conditions were evaluated by modified Rankin scale(mRS).Results ADAPT was performed 2.0±1.8 times in average in this study.The mean time between onset and femoral artery puncture was 360.8±170.9 min,and the mean time between femoral artery puncture and vascular recanalization was 133.1±43.2 min.Eleven patients were achieved effective recanalization(TICI grade 2b to grade 3)immediately after operation,including TICI grade 3 in 7 patients,grade 2b in 4 and grade 2a in 1.There was significant difference in NIHSS score before and after the operation(P<0.05).Two patients died.Ten patients were followed up for 90 days,mRS score showed 1 point in 5 patients,3 points in 2,4 in 1 and 5 in 2.Conclusion ADAPT is safe and effective for acute large vascular occlusive stroke.
作者
高培龙
苏景良
李建伟
郝占坡
苏娅
崔艳红
Gao Peilong;Su Jingliang;Li Jianwei;Hao Zhanpo;Su Ya;Cui yanhong(Department of Cerebrovascular Disease,Beijing Chaoyang Integrative Medicine Emergency Medical Center,Beijing 100022,China;NO.3 Department of Neurosurgery,Characteristic Medical Center of Chinese Armed Police Force,Tianjin 300162,China)
出处
《中国微侵袭神经外科杂志》
CAS
2021年第1期11-14,共4页
Chinese Journal of Minimally Invasive Neurosurgery
关键词
脑梗死
急性大血管闭塞
直接抽吸首次通过技术
溶栓
brain infarction
acute large vessel occlusions
a direct aspiration first-pass technique
thrombolysis
