支架置入术在颅内大血管急性闭塞血流重建中的疗效研究  

Therapeutic effect of stent implantation on recanlization in intracranial acute large vessel occlusion

作　　者：罗生辉 张帆[3] 杨永凯 周晓辉 吴彩松 丁艺航 Luo Shenghui;Zhang Fan;Yang Yongkai;Zhou Xiaohui;Wu Caisong;Ding Yihang(Department of Neurology,Affiliated Fujian No.1 Hospital of Fujian Medical University,Fuzhou 350009,Fujian Province China)

机构地区：[1]福建医科大学附属福州市第一医院神经内科,350009 [2]福建医科大学附属福州市第一医院神经外科,350009 [3]厦门大学附属福州市第二医院神经外科

出　　处：《中华老年心脑血管病杂志》2020年第11期1185-1188,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：福建省重大专项专题项目(2015YZ0003-1);福州市卫生计生科技创新平台建设项目(2018-S-wp2)。

摘　　要：目的探讨急性期支架置入术在急性前循环大血管闭塞性缺血性脑卒中血流重建中的有效性及安全性。方法前瞻性收集经机械取栓后血管狭窄程度仍>50%的急性前循环大血管闭塞性脑梗死患者61例,随机分成支架组31例和药物组30例,支架组在颅内球囊扩张后选择合适大小的Enterprise支架或取栓支架(Solitair-FR)直接解脱,药物组不置入支架。评估患者术后90 d血管再通情况、预后、症状性颅内出血及病死率。结果支架组即刻血管再通率明显高于药物组(93.5%vs 66.7%,P=0.021)。术后90 d,支架组18例血管狭窄程度≥50%;8例闭塞,血管再通23例;药物组血管再通12例,支架组术后90 d血管再通率明显高于药物组(74.2%vs 40.0%,P=0.007);2组预后良好率、颅内出血率及病死率比较,差异无统计学意义(P>0.05)。结论支架置入术可明显提高前循环大血管急性闭塞患者90 d后的血管再通率,安全性与药物治疗相当,但90 d良好预后无明显差异。Objective To study the efficacy and safety of stent implantation for recanaliztion in patients with ischemic stroke due to acute anterior circulation large vessel occlusion.Methods Sixty-one patients with cerebral infarction due to acute anterior circulation large vessel occlusion with their angiostenosis>50%after mechanical thrombectomy were randomly divided into stent group(n=31)and drug group(n=30).Enterprise stent or Solitair-FR sent was implanted into the patients of stent group and no stent was implanted into those of drug group.The recanalization,outcome,symptomatic intracranial hemorrhage and death rate in two groups were evaluated on day 90 after thrombectomy.Results The immediate recanalization rate was significantly higher in stent group than in drug group(93.5%vs 66.7%,P=0.021).The angiostenosis was≥50%in 18 patients of stent group with occlusion and the recanalization was detected in 8 and 23 patients respectively on day 90 after thrombectomy.The recanalization was achieved in 12 patients of drug group and the recanalization rate was significantly higher in stent group than in drug group(74.2%vs 40.0%,P=0.007).No significant difference was detected in the rate of good outcome,intracranial hemorrhage and death between the two groups(P>0.05).Conclusion Stent implantation can effectively improve the recanalization rate in patients with acute anterior circulation large vessel occlusion on day 90 after thrombectomy.The safety of stent implantation is similar to that of drug treatment with no significant difference in good outcome.

关 键 词：支架 卒中 颅内栓塞 动脉闭塞性疾病 球囊取栓术 

分 类 号：R651.12[医药卫生—外科学]