经ACE导管血栓抽吸术治疗急性大血管闭塞性脑梗死的疗效及安全性评价  

Evaluation of the Efficacy and Safety of Thrombus Aspiration Via Ace Catheter in the Treatment of Acute Large Vessel Occlusive Cerebral Infarction

作　　者：刘洋[1] 魏成群 祝琳琳[1] 闫丽 高宏伟[1] LIU Yang;WEI Chengqun;ZHU Linlin;YAN Li;GAO Hongwei(Heilongjiang Provincial Hospital,Harbin 150000,China)

机构地区：[1]黑龙江省医院,黑龙江省哈尔滨市150000

出　　处：《实用心脑肺血管病杂志》2020年第S02期29-31,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨经ACE导管血栓抽吸术治疗急性大血管闭塞性脑梗死的疗效及安全性。方法选取2019年1月—2020年10月在黑龙江省医院神经外科住院治疗的急性大血管闭塞性脑梗死患者40例,对其临床资料进行回顾性分析。其中常规支架取栓18例(常规组),经ACE导管血栓抽吸术治疗22例(ADAPT组),比较两组手术时间、术后血管再通率、术前与术后7 d美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分、血栓逃逸、补救措施率、脑出血和死亡率。采用改良RANKIN量表评分(modified Rankin scale,mRs)评估预后,比较两组神经功能恢复良好(mRs≤2级)率。结果两组闭塞血管再通成功率、血管再通时间、血栓逃逸率、补救措施率、脑出血率和死亡率差异均无统计学意义(P>0.05),术后两组NIHSS评分均明显低于术前(P<0.05),ADAPT组评分明显低于常规组(P<0.05),功能良好恢复率(mRs≤2级)高于常规组(P<0.05)。结论经ACE导管血栓抽吸术治疗急性大血管闭塞性脑梗死是一种安全、有效的血管内再通手段,在实现闭塞血管再通、改善术后NIHSS评分、远期预后等方面均有一定优势。Objective To explore the efficacy and safety of thrombus aspiration via ACE catheter in the treatment of acute large vessel occlusive cerebral infarction.Methods 40 patients with acute large vessel occlusive cerebral infarction who were hospitalized in our hospital from January 2019 to October 2020 were selected,and their clinical data were retrospectively analyzed.Among them,18 cases were treated with conventional stent thrombus removal(conventional group),and 22 cases were treated by ACE catheter thrombus aspiration(ADAPT group).The operation time,postoperative vascular recanalization rate,preoperative and postoperative 7 days were compared between the two groups.National Health Research National Institutes of Health Stroke Scale(NIHSS)scores,thrombus escape,rate of remedial measures,cerebral hemorrhage and mortality were compared.The modified RANKIN scale(modified Rankin scale,mRs)was used to evaluate the prognosis,and the rate of good neurological recovery(mRs≤2)between the two groups was compared.Results There was no significant difference in the success rate of occluded vessel recanalization,vessel recanalization time,thrombus escape rate,remedial measures rate,cerebral hemorrhage rate,and mortality between the two groups(P>0.05),and the NIHSS scores of the two groups were significantly lower than that before operation(P<0.05),the score of ADAPT group was significantly lower than that of conventional group(P<0.05),and the recovery rate of good function(mRs≤2)was higher than that of conventional group(P<0.05).Conclusion Thrombus aspiration via ACE catheter is a safe and effective means of intravascular recanalization for acute large vessel occlusive cerebral infarction.It can achieve recanalization of occluded vessels,improve postoperative NIHSS score,longterm prognosis and reduce mortality.Both have certain advantages.

关 键 词：ACE抽吸导管 血栓抽吸技术 急性大血管闭塞性脑梗死 血管再通 疗效 安全性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]