急性前循环脑梗死在发病5~9小时后机械取栓评估分析  

Prognosis of thrombectomy on anterior circulation infarction within 5-9 hours after onset

作　　者：董立朋[1] 赵景茹[1] 康林[1] 楚宝 高雅然[1] 吴宗锴 牛小莉[1] 李俐涛[1] 王贺波[1] Dong Lipeng;Zhao Jingru;Kang Lin;Chu Bao;Gao Yaran;Wu Zongkai;Niu Xiaoli;Li Litao;Wang Hebo(Department of Neurology, the Hebei People’s Hospital, Shijiazhuang 050051, China)

机构地区：[1]河北省人民医院神经内科,石家庄050000

出　　处：《脑与神经疾病杂志》2019年第10期615-618,共4页Journal of Brain and Nervous Diseases

基　　金：河北省医学科学研究重点课题(20170342).

摘　　要：目的 探讨机械取栓在多模式影像指导下治疗急性前循环脑梗死的临床疗效。方法 选取河北省人民医院神经内科2016年10月至2018年7月发病5~9h急性前循环脑梗死患者42例,分为2组,常规治疗组和多模式影像指导下机械取栓组。以治疗后24h、7d、90d美国国立卫生研究院卒中量表(NIHSS)评分及90d随访时改良Rankin量表(mRs)评分、Barthel指数评估治疗的有效性。结果 常规治疗组和机械取栓组,两组患者基线信息的差异均无统计学意义(均P>0.05);两组患者治疗后24h、7h、90d美国国立卫生研究院卒中量表(NIHSS)评分(P<0.01)、临床结局的差异也均有统计学意义(P<0.05)。结论 机械取栓术在多模式影像指导下治疗发病5~9h的急性循环脑梗死患者能改善神经功能,临床预后较好。Objective To investigate the prognosis of thrombectomy on anterior circulation infarction within 5-9 hours after onset guided by multimodal CT or multimodal MRI. Methods Patients with acute ischemic anterior circulation stroke were recruited, within 5-9 hours after onset, at the Hebei General Hospital from October 2016 to July 2017 consecutively. All of 42 patients were divided into 2 groups randomly to receive standard therapy or endovascular thrombectomy guided by multimodal CT or multimodal MRI. Neurological deficits were assessed before thrombectomy, 24 h, 7 days, and 90 days after mechanical thrombectomy by NIHSS score. At the 90 days follow-up visit, functional rehabilitation was evaluated using the modified Rankin Scale and Barthel Index. Results There was no significant difference in baseline information between the groups( P > 0.05). Patients who received mechanical thrombectomy had significantly better neurological functions at 24 h, 7 days, and 90 days( P < 0.05), as well as good prognosis(mRs0-2, Barthel ≥ 95)compared to the standard therapy group( P< 0.05). Conclusion The study demonstrated that mechanical thrombectomy could significantly improve neurological functions and prognosis in patients with acute ischemic anterior circulation stroke at broadened therapeutic window(5 to 9 hours) under multimodal CT and multimodal MRI imaging.

关 键 词：前循环梗死 机械取栓 多模影像 时间窗 

分 类 号：R743.32[医药卫生—神经病学与精神病学]