机械取栓治疗急性缺血性脑卒中预后的评估  

Evaluation of Prognosis of Mechanical Thrombectomy in the Treatment of Acute Ischemic Storke

作　　者：樊丹丹 屈秋民[1] 高烨[1] FAN Dandan;QU Qiumin;GAO Ye(Emergency Department,the First Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710061 ,China)

机构地区：[1]西安交通大学第一附属医院急诊科,西安710061

出　　处：《解放军预防医学杂志》2018年第3期361-363,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：国家"十二五"科技支撑计划资助项目(No.2011BAI08B05)

摘　　要：目的探讨机械取栓治疗急性缺血性脑卒中的预后。方法选取我院2016年1月至2017年7月收治的急性缺血性脑卒中患者128例,将机械取栓治疗者设为组1共42例,内科保守治疗者设为组2共86例。分析比较两组间预后指标:治疗24 h后△NIHSS评分等级,治疗1个月后mRS评分等级,颅内出血例数及住院天数。结果性别、年龄、高血压史、糖尿病史、吸烟史、卒中史、发病到治疗时间、入院时NIHSS评分、颅内病变部位、颅内病变血管这些因素在两组之间比较差异无统计学意义(P>0.05);两组之间△NIHSS评分比较有统计学意义(P<0.05),组1显效率(19.1%)高于组2(12.8%),组1有效率(21.4%)高于组2(7.0%),组1无效率(59.5%)低于组2(80.2%);两组治疗1个月后mRS评分等级比较有统计学意义(P<0.05),组1恢复优的比率(16.7%)高于组2(11.6%),组1恢复良的比率(38.1%)高于组2(25.6%),组1恢复差的比率(40.5%)低于组2(58.1%),组1死亡率(4.8%)和组2(4.7%)大致相仿。颅内出血比率及住院天数在两组之间比较无统计学意义(P>0.05)。结论在急性缺血性脑卒中治疗中,机械取栓的预后较内科保守治疗预后好。Objective To study the prognosis of mechanical thrombectomy in the treatment of acute ischemic storke（ AIS）.Methods A total of 128 patients diagnosed with AIS were treated with medical therapy and mechanical thrombectomy between January 2016 and July 2017. Forty-two patients treated with mechanical thrombectomy were recruited as Group A,while eighty-six patients under medical therapy were recruited as Group B.△NIHSS score after 24 hours of treatment,mRS grade at one month,the amount of intracranial hemorrhage,and hospital stay were compared between the two groups. Results There was no significant difference in gender,age,hypertension,diabetes,habits of smoking and history of stroke,the time interval between the onset to the beginning of treatment,NIHSS scores on admission,lesion sites,lesion vessels between the two groups（ P〉0.05）. There was statistically significant differences in △NIHSS scores at 24 hours of treatment（ P〈0.05）.The rate of explicit efficiency of Group A（ 19.1%） was higher than that of Group B（ 12.8%）,the rate of efficiency of Group A（ 21.4%） was higher than that of Group B（ 7.0%）,but the rate of inefficiency of Group A（ 59.5%） was lower than that of Group B（ 80.2%）. There was statistically significant differences in mRS grade at one month（ P〈0.05）. The rate of explicit efficiency of Group A（ 16.7%） was higher than that of Group B（ 11.6%）,the rate of efficiency of Group A（ 38.1%） was higher than that of Group B（ 25.6%）,the rate of inefficiency of Group A（ 40.5%） was lower than that of Group B（ 58.1%）,and the death rate of Group A（ 4.8%） was equal to that of Group B（ 4.7%）. There was no significant difference in the rate of intracranial hemorrhage or hospital day（ P〉0.05）.Conclusion In the treatment of AIS,the prognosis of mechanical thrombectomy is better than that of medical therapy.

关 键 词：急性缺血性脑卒中 机械取栓 保守治疗 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]