补救性血管成形术在大动脉闭塞性急性缺血性脑卒中的应用研究  

Efficacy and safety of rescue angioplasty for acute ischemic stroke patients with large artery occlusion

作　　者：夏文卿 蒋琳[1] 卜香叶 黄焕 牛国忠[1] 殷聪国[1] XIA Wenqing;JIANG Lin;BU Xiangye;HUANG Huan;NIU Guozhong;YIN Congguo(Department of Neurology,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院神经内科,310006

出　　处：《浙江医学》2021年第8期875-878,881,共5页Zhejiang Medical Journal

基　　金：杭州市医药卫生科技计划项目(2017A04)。

摘　　要：目的观察补救性血管成形术治疗大动脉闭塞性急性缺血性脑卒中(AIS)的有效性及安全性。方法收集2016年6月至2018年7月在浙江大学医学院附属杭州市第一人民医院神经内科接受机械取栓(MT)术的大动脉闭塞性AIS患者223例,根据是否行补救性血管成形术,将患者分为血管成形术组和单纯MT组两组。比较两组患者血管再通率、症状性颅内出血(sICH)和90 d后的临床疗效。结果223例患者中,行补救性血管成形术62例,行单纯MT术161例。两组患者血管再通率(96.8%比96.3%)、sICH发生率(8.1%比8.1%)、90 d良好预后(53.2%比54.0%)和90 d死亡率(21.0%比19.9%)比较差异均无统计学意义(均P>0.05)。结论补救性血管成形术可以改善大动脉闭塞性AIS患者的功能性预后,且不会增加sICH发生率和90 d死亡率。Objective To evaluate the safety and efficacy of rescue angioplasty for acute ischemic stroke(AIS)patients with large artery occlusion.Methods Clinical data of 223 patients with AIS caused by large artery occlusion who underwent mechanical thrombectomy(MT)from June 2016 to July 2018 in the Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine were retrospectively analyzed,including 62 cases receiving rescue angioplasty,and 161 cases receiving MT only.The vascular recanalization rate,symptomatic intracranial hemorrhagic(sICH),and clinical efficacy after 90 days were compared between two groups.Results There were no significant differences in vascular recanalization rate(96.8%vs.96.3%),sICH(8.1%vs.8.1%),functional independence at 90 days(53.2%vs.54.0%),and the mortality rate at 90 days(21.0%vs.19.9%)between two groups(all P>0.05).Conclusion Rescue angioplasty is independently associated with good outcomes without increasing sICH or mortality for patients with AIS caused by large artery occlusion.

关 键 词：急性缺血性脑卒中 机械取栓 血管成形术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]