前循环大动脉闭塞高龄患者血管内支架取栓治疗疗效及安全性分析  

Efficacy and safety of endovascular thrombectomy for elderly stroke patients with anterior circulatory artery occlusion

作　　者：潘婕[1] 史宗杰[1] 施天明[1] 王美萍[1] 郭舜源[1] 耿昱[1] PAN Jie;SHI Zongjie;SHI Tianming(Department of Neurology,Zhejiang Provincial People’s Hospital,Hangzhou 310014,China)

机构地区：[1]浙江省人民医院( 杭州医学院附属人民医院)神经内科,杭州310014

出　　处：《浙江医学》2019年第4期314-317,321,共5页Zhejiang Medical Journal

基　　金：浙江省医学卫生科技项目(2019RC099);浙江省科技计划重点研发项目(2018C03008);浙江省医药卫生科技项目(2018274810);浙江省自然科学基金(LQ14H090011)

摘　　要：目的分析血管内支架取栓治疗对前循环大动脉闭塞高龄患者的有效性及安全性。方法回顾性分析2015年3月至2016年12月因前循环血管闭塞(颈内动脉、大脑中动脉M1段)导致急性缺血性脑卒中行血管内支架取栓治疗的患者69例,将年龄≥80岁的17例患者作为高龄组,<80岁的52例作为对照组,比较两组患者的临床特征和血管内支架取栓治疗的颅内出血风险及90d良好预后。结果高龄组90d mRS评分5(3,6)分,高于对照组的3(1,5)分,差异有统计学意义(P<0.05)。两组血管再通比例,总体颅内出血、症状性出血以及90d良好预后比较,差异均无统计学意义(均P>0.05)。结论≥80岁的前循环大动脉闭塞急性缺血性脑卒中患者可进行血管内支架取栓治疗。Objective To analysis the efficacy and safety of the endovascular thrombectomy for elderly stroke patients with anterior circulatory artery occlusion.Methods Clinical data of 69 stroke patients with anterior circulatory artery occlusion undergoing endovascular thrombectomy in Zhejiang Provincial People's hospital from March 2015 to December 2016 were retrospectively analyzed,including 17 patients aged≥80 year(elderly group)and 52 patients aged<80 year(control group).The prognosis in 90d and the risk of intracranial hemorrhage were evaluated and compared between two groups.Results There were no significant differences between two groups in the sex and the risk factors of stroke.The 90d mRS score of elderly group was higher than that of control group[5(3,6)vs.3(1,5),P<0.05].However,there were no significant differences in incidence of intracranial hemorrhage(χ^2=0.845,P=0.397)and symptomatic intracranial hemorrhage(χ^2=0.049,P=1.000)and the favorable prognosis rate in 90d(χ^2=7.000,P=0.066)between two groups.Conclusion For the elderly stoke patients with anterior circulatory artery occlusion,the endovascular thrombectomy is still effective and safe.

关 键 词：急性缺血性卒中 血管内治疗 前循环 高龄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]