Solitaire支架动脉取栓术联合多模式血管再通术治疗急性脑梗死疗效观察  

The clinical observation on the treatment of acute cerebral infarction by combining Solitaire stent arterial embolectomy with multi-mode vascular recanalization

作　　者：傅懋林[1] 戴为正[1] 张永刚 肖雪玲[1] 王双虎[1] 何文钦[1] 

机构地区：[1]解放军第180医院神经内科,福建省泉州市362000

出　　处：《天津医药》2017年第10期1053-1057,共5页Tianjin Medical Journal

摘　　要：目的探讨Solitaire支架动脉取栓术联合多模式血管再通术治疗急性脑梗死的有效性及安全性。方法收集2014年11月—2017年2月我院采用动脉取栓术联合多模式血管再通技术治疗急性脑梗死患者22例(研究组),其中动脉取栓后联合球囊扩张术16例,支架置入术4例(Solitair支架3例,Apollo支架1例),动脉溶栓术2例。另择我科2011年10月—2014年10月单纯采用Solitaire支架动脉取栓治疗的颅内大血管闭塞急性脑梗死患者18例作为对照组。比较2组发病时间至置鞘时间,发病至血管再通时间,血管内介入治疗术的血管再通情况,入院及出院时NIHSS评分及90 d时mRS评分,并发症及死亡的发生情况。结果 2组发病时间至置鞘时间及发病至血管再通时间差异均无统计学意义。研究组血管再通情况明显优于对照组(P<0.05)。2组入出院时NIHSS评分变化值差异无统计学意义,近期疗效相近。而研究组90 d后mRS评分明显低于对照组(P<0.05)。2组患者症状性颅内出血、高灌注脑病、操作相关并发症的发生率及死亡率差异无统计学意义。结论 Solitaire支架动脉取栓术联合多模式血管再通术治疗急性脑梗死,可提高患者的血管再通率,改善患者远期临床预后,提高患者生存质量,且不增加并发症发生率及死亡率,安全有效。Objective To explore the efficacy and safety of Solitaire stents and the multi-mode vascular recanalizationin the treatment of acute cerebral infarction. Methods Twenty-two patients with acute cerebral infarction, who weretreated by Solitaire stents and the multi-mode vascular recanalization(research group) in our hospital from November 2014 to February 2017, were included in this study. Among them, 16 cases were combined with balloon dilation after arterialthrombosis, 4 cases were given stent implantation(3 cases were given Solitair stent and 1 case was given Apollo stent), and 2 cases were given arterial catheter directed thrombolysis. Eighteen patients with acute cerebral infarction who were treatedonly by Solitaire stent artery occlusion from October 2011 to October 2014 were used as control group. Data of the onset tothe vagina vasorum time, the onset to the recanalization time, the revascularization of interventional therapy, the NIHSSscores at admission and discharge, mRS score after 90-day treatment, incidence rate and the mortality were comparedbetween two groups. Results There were no significant differences in the durations from onset to the vagina vasorum andfrom the onset to the recanalization between the two groups. The recanalization was better in research group than that ofcontrol group(P<0.05). There were no significant differences in scores of NIHSS at hospital discharge and admissionbetween two groups. The near-term treatment efficacy was similar in two groups. However, mRS score was significantly lowerin the research group than that in control group after 90-day treatment(P < 0.05). There were no significant differences inthe symptomatic intracranial hemorrhage, high perfusion encephalopathy, the incidence rate and the mortality rate of thecomplications related to the operation between two groups of patients. Conclusion Solitaire stents and the multi-modevascular recanalization can significantly improve the revascularization, the further clinical prognosis and the quality of survival in patien

关 键 词：脑梗死 动脉取栓术 多模式血管再通术 心源性脑栓塞 血管再通率 临床预后 安全性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]