急性颅内动脉闭塞分期介入梯度再通术的临床应用和预后评价  

Clinical application of staging grads interventional recanalization to acute intracranial artery occlusion and its prognostic evaluation

作　　者：胡立民 胡深[2] 颜杰浩[2] 温清[2] 

机构地区：[1]解放军65176部队 [2]广东医学院附属深圳南山医院神经外科

出　　处：《临床军医杂志》2013年第8期812-815,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨对急性颅内动脉闭塞采用分期介入梯度再通术治疗的临床应用和预后评价。方法对36例前循环颅内动脉急性闭塞行分期介入梯度治疗,早期采用小径球囊经皮腔内成形术(PTA)或联用小剂量尿激酶(UK);后期使用支架成形术(PTS),评估复通术后出血性转化发生率和成形术后相关性血栓事件的出现率及其总体预后。结果 3例在PTA期发生出血性转化,其中1例需外科处理,2例遗有明显神经功能障碍,PTS期无支架相关性血栓形成终点事件发生,无全因性死亡。结论对急性颅内动脉闭塞采用分期介入梯度再通术,既可达到有效缓解早期的缺血性状态,同时预防出血性转化,又可明显解除后期残留狭窄,降低术源性血栓事件的发生率。但长期疗效尚需进一步研究。Objective To discuss the clinical application of staging grads interventional recanalization to acute intracranial artery occlusion and its prognostic evaluation. Methods A total of 36 patients with acute intraeranial artery occlusion in anterior circula- tion were treated with staging grads endovascular therapy, i.e. percutaneous transluminal angioplasty （PTA） via smaller diameter balloon or additional small dosage of urokinase （UK） in early phase （ acute phase） and via percutaneous transluminal stentiug （PTS） in late phase. Evaluate was done in terms of the incidence of hemorrhagic transformation and thrombosis event. Results Of the patients, three suffered from hemorrhagic transformation during PTA, one of whom needed surgery treatment and two of whom had remained severe dysfunction, neither thrombosis complications relative to PTS nor death in the group. Conclusion Staging grads interventional recanalization for acute intracranial artery occlusion is effective on improvement in the states of ischemia in early onset and prevention of hemorrhagic transformation from the reeanalization. It helps to make the patients free of residual stenosis from PTA, and to lower the rate of the thrombosis relative to PTS. But its long-term prognosis needs more studies.

关 键 词：急性颅内动脉闭塞 分期介入梯度再通术 经皮腔内血管成形术 经皮腔内血管支架术 出血性转化 血栓性事件 

分 类 号：R743[医药卫生—神经病学与精神病学]