急性椎基底动脉闭塞血管内介入治疗的疗效分析  

The curative effect analysis of endovascular interventional therapy for acute vertebrobasilar arterial occlusions

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

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

出　　处：《河南外科学杂志》2017年第5期1-3,共3页Henan Journal of Surgery

基　　金：广东惠州市2013年科技计划项目(20130802)

摘　　要：目的探讨血管内介入治疗急性椎基底动脉闭塞的效果及影响因素。方法惠州市第一人民医院于2013-01—2016-12间采用血管内介入疗法治疗急性椎基底动脉闭塞患者共13例,其中尿激酶动脉溶栓+碎栓3例,溶栓+碎栓+Solitaire支架拉栓10例,必要时进行球囊扩张血管狭窄处。回顾性分析患者的临床资料、即时取栓效果、疗效,总结并发症的预防经验。结果术后即刻造影及复查头颅CT显示,血管完全再通10例,部分再通2例,未再通1例,再通率为92%。术后复查CT显示无脑出血病例,较大面积脑干梗死5例。良好功能恢复(MRS评分0~2分)6例,中度残疾(MRS评分3分)2例,严重功能障碍(MRS评分4~5分)3例,死亡1例。结论血管内介入治疗急性椎基底动脉血栓形成,血管再通率高,安全、有效,部分患者预后良好。Objective To discuss the effect and influence factors of endovascular interventional therapy for acute vertebrobasilar arterial occlusions. Methods To conduct a retrospective analysis on the 13 cases of patients with acute vertebrobasilar arterial occlusions who were treated by endovascular interventional therapy in The First People＇s Hospital of Huizhou City from January 2013 to December 2016,including 3cases of urokinase intra-arterial thrombolysis ＋ fragmentation,10 cases of thrombolysis ＋ fragmentation ＋ Solitaire stent placement,and balloon dilatation of vascular stenosis as occasion requires. To analyze the clinical data,the effects of instant thrombus extraction curative effects of patients,curative effects and to summarize experiences in the prevention of complications. Results Immediate postoperative angiography and skulls CT reviewing showed that there were 10 cases of full revascularization,2 cases of partial revascularization and only 1 case of non-recanalization. The rate of revascularization is 92%. Postoperative CT reexamination showed that there were no cerebral hemorrhage cases and 5 cases of large area of brain stem infarction. There were 6 cases with good functional recovery（ The MRS evaluation is 0 ~ 2 scores）,3 cases of severe disfunction（ The MRS evaluation is 3 ~ 4 scores） and 1 case of death. Conclusion The rate of revascularization is high for patients treated by endovascular interventional therapy for acute vertebrobasilar arterial occlusions. The therapy is relatively safe and effective. Most of patients treated by this therapy have favorable prognosis.

关 键 词：椎基底动脉 动脉闭塞性疾病 动脉溶栓 机械开通 支架 

分 类 号：R743[医药卫生—神经病学与精神病学]