急性缺血性脑卒中的血管内介入治疗疗效分析（附32例报告）  

Endovascular intervention in treating acute cerebral stroke： a report of 32 cases

作　　者：景英朝[1] 姚晓腾[1] 郑定柯 刘克君[1] 谢乙团[1] 荆国杰[1] 

机构地区：[1]惠州市第一人民医院神经外科,惠州市神经外科研究所,516000

出　　处：《中华神经医学杂志》2014年第6期610-613,共4页Chinese Journal of Neuromedicine

基　　金：惠州市2013年科技计划项目（20130802）

摘　　要：目的分析血管内介入治疗急性缺血性脑卒中的疗效。方法惠州市第一人民医院神经外科自2010年1月至2013年10月采用血管内介入治疗急性缺血性脑卒中患者32例（大脑中动脉闭塞22例，颈内动脉闭塞10例1，其中重组组织型纤溶酶原激活剂（r-tpA）及尿激酶动脉溶栓＋碎栓14例，溶栓＋碎栓＋Solitaire支架拉栓18例。回顾性分析患者的临床资料和疗效，总结并发症的预防经验。结果本组患者复查头颅CT显示血管完全再通18例，部分再通5例，未再通9例。血管再通率为71％。术后发生症状性脑出血2例（6％），发生大面积脑梗死1例（3．1％）。1月后复查MRI脑梗死范围均有所缩小。患者美国国立卫生院神经功能缺损评分（NIHSS）4～6分，预后良好23例（72％），9例患者遗留较重神经功能障碍，肢体肌力小于Ⅲ级。结论血管内介入治疗急性缺血性脑卒中患者，可达到较高的血管再通率、获得较好疗效。Objective To evaluate the effectiveness of endovascular intervention in treating acute cerebral stroke. Methods Thirty-two patients with acute cerebral stroke （22 with middle cerebral artery occlusion and 10 with internal carotid artery occlusion）, admitted to and treated with endovascular intervention in our hospital from January 2010 to October 2013, were chosen in our study; 14 were performed arterial thrombolysis＋mechanical fragrnengation and 18 were performed mechanical fi＇agmengation＋ solitaireAB stent thrombectomy. Retrospective analysis was performed on the clinical data and treatment efficacy, and the prevention experience of complications was concluded. Results CTA showed that complete recanalization was noted in 18 patients and partial recanalization in 5, with a recanalization rate reaching 7 1%. Postoperative symptomatic intracerebral hemorrhage was noted in 2 patients （6%） and 1 （3.1%） had large area of cerebral infarction. One month after the treatment, MRI indicated decreased areas of infarction in all patients. NlttSS scores were 4-6 points of all patients; favorable prognosis was noted in 23 patients （72%）. Nine patients had heavy neurological dysfunction, with limb muscle strength less than grade llI. Conclusion Endovascular intervention in treating acute cerebral stroke can get high recanalization rate, and achieve good clinical outcome.

关 键 词：急性缺血性脑卒中 动脉溶栓 机械碎栓 支架拉栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]