Solitaire支架机械取栓术后血管再闭塞病因分析及防治策略  

Analysis of the Cause of Reocclusion of Blood Vessels after Solitaire Stent Mechanical Thrombectomy and Iits Pvention and Treatment Strategy

作　　者：周志国[1] 陈静[1] 朱青峰[1] ZHOU Zhiguo;CHEN Jing;ZHU Qingfeng(PLA 264st Hospital,Taiyuan 030000,Chin)

机构地区：[1]解放军264医院,山西太原030000

出　　处：《中国医学创新》2018年第16期5-9,共5页Medical Innovation of China

基　　金：2012年,2016年山西省科技攻关课题(20120313018-2;201603D321061)

摘　　要：目的:探讨急性缺血性脑卒中患者机械取栓术后血管再闭塞的病因及预防机制。方法:收集2016年12月-2017年12月共计21例急性缺血性脑卒中患者,行血管内介入机械取栓治疗,采用mTICI评分及NIHSS评分评价血管再通情况,分析血管再闭塞原因及与相关危险因素的关系。结果:责任血管无粥样硬化者,血管再通率较高为84.62%(P=0.023);取栓次数大于3次者,血管闭塞的比率明显增加为80.00%(P<0.05);取栓时间窗超过6 h的血管闭塞发生比率明显增加80.00%(P<0.05);穿支血管再通,即mTIC分级在2b及3级以上者,血管再通率明显升高为83.33%(P<0.05)。结论:加强对各种危险因素的控制,综合应用Solitaire支架取栓、动脉溶栓、球囊扩张、支架置入及预见性去骨瓣减压、内减压等多模式手术方式,能有效提高急性缺血性脑卒中Solitaire支架机械取栓术后血管再通率。Objective：To explore the causes and prevention mechanism of postoperative blood vessel reocclusion in patients with acute ischemic stroke. Method：A total of 21 cases with acute ischemic stroke were collected from December 2016 to December 2017,they were given treating line of intravascular intervention in machinery,recanalization mTICI grading and NIHSS score evaluation,the reasons of blood vessels and block and related risk factors of relationship were analyzed.Result：The recanalization rate of no responsibility of vascular atherosclerosis was higher of 84.62%（P=0.023）.Thrombectomy number greater than 3 times, the ratio of vascular occlusion was significantly increased of 80.00%（P〈0.05）.Thrombectomy time window over 6 h vascular occlusion increased significantly of 80.00%（P〈0.05）.Perforator vascular recanalization that is in mTIC grade 2B and 3 grade above,the recanalization rate was significantly increased of 83.33%（P〈0.05）.Conclusion：Strengthen the control of various risk factors, Comprehensive application of Solitaire stent thrombectomy, arterial thrombolysis, balloon dilatation, stent implantation and predictive decompressive craniectomy, internal decompression and other multi-mode operation can effectively improve the vascular recanalization rate after Solitaire stent mechanical thrombectomy for acute ischemic stroke.

关 键 词：机械取栓术 并发症 血管闭塞 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]