超时间窗急性前循环缺血性脑卒中机械取栓治疗效果分析  

Analysis of the effect of mechanical thrombectomy for acute anterior circulation ischemic stroke in over-time window

作　　者：曹姗[1] 刘永刚[1] 董辉[1] 邢晓明[1] 孟会红 钱倩 任翠剑 高爱民[1] CAO Shan;LIU Yonggang;DONG Hui(Department of Neurology,Baoding No.1 Central Hospital,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院神经内科,河北保定071000

出　　处：《中风与神经疾病杂志》2021年第4期326-329,共4页Journal of Apoplexy and Nervous Diseases

基　　金：河北省中医药管理局(2018433);保定市科技计划项目(18ZF198)。

摘　　要：目的分析机械取栓(MT)在超时间窗急性前循环缺血性脑卒中(AACIS)患者中的治疗效果。方法选取2018至1月-2018年11月期间,我院收治的采用MT治疗的AACIS患者40例作为研究对象。根据随发病-治疗时间不同,将患者分为时间窗内组(发病-治疗时间≤6 h,n=30)和超时间窗组(发病-治疗时间>6 h,n=10)。以改良脑梗死溶栓(mTICI)分级评价治疗效果,对比患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分以评价神经功能缺损程度改善情况,对比术后90 d改良Rankin量表(mRs)评分、并发症发生率和死亡率以评价预后。结果时间窗内组患者治疗成功率为83.33%(25/30),超时间窗组患者治疗成功率为80.00%(16/20),两组患者治疗成功率比较,差异无统计学意义(P>0.05)。两组患者出院时NIHSS评分均低于入院时,差异具有统计学意义(P<0.05),两组患者出院时NIHSS评分比较,差异无统计学意义(P>0.05)。术后90 d内,两组患者均无死亡病例出现。两组患者预后良好率、并发症发生率比较,差异无统计学意义(P>0.05)。结论MT在超时间窗AACIS患者的治疗中,可有效改善患者血管再通率,具有与时间窗内患者相似的近远期治疗效果。Objective To analyze the therapeutic effect of mechanical thrombectomy(MT)in patients with acute anterior circulation ischemic stroke(AACIS)in over-time window.Methods From January 2018 to November 2018,40 patients with AACIS treated with MT were enrolled in our hospital.Patients were divided into in-time-window group(onset-treatment time≤6 h,n=30)and over-time-window group(onset-treatment time>6 h,n=10)according to the time of onset-treatment.The therapeutic effect was evaluated by modified thrombolysis in cerebral infarction(mTICI).The National Institutes of Health Stroke Scale(NIHSS)scores were compared before and after treatment to evaluate the improvement of neurological deficits.The modified Rankin scale(mRs)score,complication rate,and mortality were compared at 90 days postoperatively to assess prognosis.Results The success rate of patients in the in-time-window group was 83.33%(25/30),and the success rate of patients in the over-time-window group was 80.00%(16/20).There was no significant difference in the success rate between the two groups(P>0.05).The NIHSS scores at the time of discharge were lower than those at admission(P<0.05).There was no significant difference in NIHSS scores between the two groups(P>0.05).Within 90 days after surgery,no deaths occurred in either group.There was no significant difference in the prognosis rate and complication rate between the two groups(P>0.05).Conclusion MT can effectively improve the recanalization rate of patients in the treatment of patients with AACIS over-time-window,and has similar short-term and long-term treatment effects as patients in the in-time-window.

关 键 词：机械取栓 超时间窗 急性前循环缺血性脑卒中 治疗效果 安全性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]