机械取栓治疗颅内大动脉闭塞性急性脑梗死后颅内出血原因分析  

Analysis of Causes of Intracranial Hemorrhage after Mechanical Thrombectomy for Acute Cerebral Infarction of Large Intracranial Artery Occlusion

作　　者：位慧芳 张珍珍 曾芳 WEI Hui-fang;ZHANG Zhen-zhen;ZENG Fang(Zhengzhou Central Hospital Affiliated to Zhengzhou University,Henan Zhengzhou 450007)

机构地区：[1]郑州大学附属郑州中心医院,河南郑州450007

出　　处：《深圳中西医结合杂志》2022年第23期22-24,共3页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:分析机械取栓治疗颅内大动脉闭塞性急性脑梗死后颅内出血的原因。方法:回顾性分析2015年1月至2021年1月郑州大学附属郑州中心医院收治的252例颅内大动脉闭塞性急性脑梗死患者的临床资料,根据治疗后有无颅内出血分为出血组(38例)、非出血组(214例),采用logistic回归分析颅内出血的危险因素。结果:出血组患者有糖尿病史、治疗前Alberta卒中项目早期CT评分(ASPECTS)评分<6分、取栓次数>3次及治疗前收缩压>160 mmHg的构成比均大于非出血组,差异具有统计学意义(P<0.05);其余资料两组间比较,差异均无统计学意义(P>0.05);多因素logistic回归分析结果显示,ASPECTS评分<6分、糖尿病史、取栓次数>3次、收缩压>160 mmHg是影响机械取栓治疗后颅内出血的危险因素(P<0.001)。结论:ASPECTS评分低、糖尿病史、取栓次数多、高血压均是机械取栓治疗颅内大动脉闭塞性急性脑梗死后颅内出血的危险因素,临床对患者开展机械取栓治疗时应重视上述指标。Objective To analyze the causes of intracranial hemorrhage after mechanical thrombectomy for acute cerebral infarction with large intracranial artery occlusion.Methods The clinical data of 252 patients with intracranial large artery occlusion acute cerebral infarction admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2015to January 2021 were retrospectively analyzed.According to the intracranial hemorrhage after treatment,they were divided into bleeding group(38 cases)and non-bleeding group(214 cases).Logistic regression was used to analyze the risk factors of intracranial hemorrhage.Results The proportion of patients with a history of diabetes,Alberta stroke program early CT score(ASPECTS)score<6,thrombectomy times>3,and systolic blood pressure>160 mmHg before treatment in the bleeding group were significantly higher than those in the non-bleeding group(P<0.05).There was no significant difference in other data between the two groups(P>0.05).Multivariate logistic regression analysis showed that ASPECTS score<6,history of diabetes,times of thrombectomy>3,and systolic blood pressure>160 mmHg were risk factors for intracranial hemorrhage after mechanical thrombectomy(P<0.001).Conclusion Low ASPECTS score,history of diabetes,more times of thrombectomy and hypertension are all risk factors for intracranial hemorrhage after mechanical thrombectomy for acute cerebral infarction with intracranial large artery occlusion.Attention should be paid to the above indicators when carrying out mechanical thrombectomy for patients.

关 键 词：急性脑梗死 颅内大动脉闭塞 机械取栓 颅内出血 

分 类 号：R743.3[医药卫生—神经病学与精神病学]