摘要
目的探讨前循环大血管闭塞急性缺血性脑卒中机械取栓后脑水肿严重程度及预后影响因素。方法选择我院行机械取栓术的前循环大血管闭塞性缺血性脑卒中患者83例。通过脑水肿严重程度分为轻度组、中度组及重度组。通过90 d改良Rankin评分量表,将患者分为预后良好组及预后不良组,使用单因素分析及Logistic回归分析对脑水肿严重程度及预后影响因素进行分析。结果经多因素回归分析,有高血压病史、基线NHISS评分>15分与脑水肿严重程度呈正相关,血管M2段及远端闭塞、成功血管再通为脑水肿严重程度呈负相关;重度脑水肿及基线NHISS评分>15分与前循环大血管闭塞患者机械取栓3个月良好预后负相关,良好侧支循环及成功血管再通与良好预后的正相关。结论基线NIHSS评分>15分、高血压病史、血管是否再通、脑血管闭塞部位为前循环大血管闭塞患者机械取栓后急性期脑水肿严重程度主要危险因素。脑水肿严重程度、基线NIHSS评分、是否血管再通及侧支循环状态为90 d后神经功能恢复的预测因素。
Objective To investigate the severity and prognostic factors of cerebral edema after mechanical thrombectomy in acute ischemic stroke with anterior circulation occlusion of great vessels.Methods Eighty-three patients with acute cerebral infarction undergone mechanical thrombotomy in our hospital were selected.According to cerebral edema.They were divided into mild group,moderate group and severe group.The patients were divided into the good prognosis group and the poor prognosis group by the improved 90 day Rankin scale.Univariate analysis and Logistic regression analysis were used to analyze the severity of cerebral edema and the prognostic factors.Results History of hypertension.baseline NHISS>15 points were positively correlated with the severity of cerebral edema.while M2 segment and distal occlusion and successful recanalization were negatively correlated with the severity of cerebral edema.Severe cerebral edema and baseline NHISS>15 were risk factors for poor prognosis 3 months and good collateral circulation and successful recanalization were predictive factors for good prognosis.Conclusion Baseline NIHSS score>15 points,history of hypertension,non-recanalization of blood vessels and occlusion of cerebral blood vessels were the predictors of the severity of cerebral edema in acute stage after mechanical thrombectomy in patients with anterior circulation occlusion of great vessels.Severity of cerebral edema,baseline NIHSS score,vascular recanalization and collateral circulation status were predictors of neurological recovery after 90 days.
作者
张梦柯
石秋艳
杨斌
王迪
张春阳
孙原
高敬华
ZHANG Mengke;SHI Qiuyan;YANG Bing(Affiliated Hospital of North China University of Science and Technology Department of Neurology,Tangshan 063000,China)
出处
《中风与神经疾病杂志》
CAS
2021年第4期306-310,共5页
Journal of Apoplexy and Nervous Diseases
基金
河北省重点研发计划项目资助课题(No.182777125D)
河北省重点科技研究计划项目资助课题(No.20191138)
河北省科技厅课题(No.182777216)。
关键词
前循环
急性缺血性脑卒中
脑水肿
Anterior circulation occlusion
Acute ischemic stroke
Cerebral edema