摘要
目的探讨分层逐段抽吸在急性高负荷血栓脑卒中取栓术中的应用价值。方法回顾性选择2020年4月至2023年6月在丽水市中心医院接受机械取栓治疗的前循环高负荷血栓大血管闭塞(LVO)性急性脑卒中患者90例,其中采用支架取栓39例,分层逐段抽吸51例。比较两组患者的手术相关资料、手术安全性及预后。结果分层逐段抽吸组患者血管成功再通率高于支架取栓组,穿刺至再通时间短于支架取栓组,7 d美国国立卫生研究院卒中量表评分低于支架取栓组,90 d预后良好率高于支架取栓组,差异均有统计学意义(均P<0.05)。两组患者血栓逃逸率、采取补救治疗率、术后症状性脑出血、90 d死亡率比较,差异均无统计学意义(均P>0.05)。结论对于前循环高负荷血栓LVO性急性脑卒中患者,分层逐段抽吸相较于支架取栓,手术时间更短、血管成功再通率及90 d预后良好率更高,有较好的临床应用价值。
Objective To evaluate the application of layered and segmented aspiration thrombectomy for patients with acute high-load thrombus stroke.Methods Clinical data of 90 acute ischemic stroke(AIS)patients with anterior circulation large vessel occlusion(LVO)and high thrombus load who underwent mechanical thrombectomy at Lishui Central Hospital between April 2020 and June 2023 were retrospectively analyzed.The patients were divided into two groups based on the surgical approach:stent retriever group(39 patients)and staged aspiration group(51 patients).Baseline demographic characteristics,surgical parameters,surgical safety,and patient outcomes were analyzed.Results The staged aspiration group had a significantly higher successful vessel recanalization rate compared to the stent retriever group(P<0.05).Additionally,the recanalization time was significantly shorter in the staged aspiration group(P<0.05).At 7 d post-procedure,the NIHSS scores were significantly lower in the staged aspiration group than those in the stent retriever group(P<0.05).Furthermore,the 90-day follow-up revealed a significantly higher rate of good functional outcomes in the staged aspiration group compared to the stent retriever group(P<0.05).There were no statistically significant differences in intraoperative thrombus escape rate,need for rescue therapy,symptomatic intracranial hemorrhage(sICH)rate,or mortality between the two groups(all P>0.05).Conclusion Compared with stent retriever,staged aspiration has a shorter operation time,a higher rate of successful vascular revascularization and a better prognosis at 90 days,which has good clinical application value.
作者
黄良通
黄逸杰
徐灵燕
彭潇
金哲宇
HUANG Liangtong;HUANG Yijie;XU Lingyan;PENG Xiao;JIN Zheyu(Department of Neurology,Lishui Central Hospital(the Fifth Affiliated Hospital of Wenzhou Medical University),Lishui 323000,China)
出处
《浙江医学》
CAS
2024年第16期1750-1753,1764,共5页
Zhejiang Medical Journal
基金
浙江省医药卫生科技计划项目(2022ZH079)。
关键词
血栓负荷评分
高负荷血栓
机械取栓
分层逐段抽吸
Thrombus load score
High thrombus load
Mechanical thrombectomy
Layered and segmental suction
