急性前循环大血管闭塞性醒后卒中直接取栓和桥接治疗的对照研究  

Comparison of clinical effect between direct mechanical thrombectomy and bridging therapy in wake-up stroke patients with acute anterior circulation large vessel occlusion

作　　者：吴雅雅 周赟[2] 张娴娴[5] 蔡秀英[2] 李波[3] 李勇刚[4] 方琪[2] 王辉[2] WU Ya-ya;ZHOU Yun;ZHANG Xian-xian(Department of Neurology,the First People's Hospital of Kunshan,Kunshan 215300,China)

机构地区：[1]昆山市第一人民医院神经内科,215300 [2]苏州大学附属第一医院神经内科 [3]苏州大学附属第一医院介入科 [4]苏州大学附属第一医院放射科 [5]盐城市第三人民医院神经内科

出　　处：《临床神经病学杂志》2021年第6期452-454,共3页Journal of Clinical Neurology

基　　金：苏州市临床重点病种诊疗技术专项(LCZX201801)。

摘　　要：目的比较急性前循环大血管闭塞性醒后卒中直接机械取栓与桥接治疗的临床疗效。方法回顾性分析2017年7月至2020年3月间收治的颅内前循环大动脉闭塞醒后卒中患者189例,根据不同治疗方法分为直接取栓组(n=141)和桥接治疗组(n=48)。对比两组患者术前基线资料、取栓术后NIHSS评分、术后7 d NIHSS评分、住院期间NIHSS评分改善例数和90 d mRS评分≥3分例数。结果直接取栓组和桥接治疗组患者间年龄、性别、高血压病、糖尿病、心房颤动、吸烟史、饮酒史比率、低密度脂蛋白胆固醇水平及基线NIHSS评分差异均无统计学意义(均P>0.05)。直接取栓组术后24 h NIHSS评分、术后7 d NIHSS评分高于桥接治疗组,但两组间差异无统计学意义(均P>0.05),且住院期间NIHSS评分比率和90 d mRS≥3分例数比率在两组间的分布差异无统计学意义(均P>0.05)。结论直接取栓和桥接治疗对急性前循环大血管闭塞的醒后卒中临床疗效相似。Objective To compare the clinical efficacy of direct mechanical thrombectomy and bridging therapy for wake-up stroke patients with acute anterior circulation large vessel occlusion.Methods A total of 189 wake-up stroke patients with acute anterior intracranial arterial infarction admitted from July 2017 to March 2020 were retrospectively analyzed.According to different treatment methods,they were divided into direct thrombectomy group(n=141)and bridging group(n=48).Preoperative baseline data,NIHSS score 24 h after thrombectomy,NIHSS score 7 d after surgery,number of patients with improved NIHSS score during hospitalization,and number of patients with mRS score≥3 points at 90 d were compared between the two groups.Results There were no statistically significant differences in the rates of age,gender,hypertension,diabetes,atrial fibrillation,smoking history,alcohol consumption history,and low density lipoprotein cholesterol level,baseline NIHSS score between the direct thrombectomy group and the bridging group(allP>0.05).NIHSS scores 24 h after surgery and 7 d after surgery in the direct thrombectomy group were higher than those in the bridging treatment group,but there was no statistically significant difference between the two groups(allP>0.05),and there was no statistically significant difference in the distribution of the rates of patients with improved NIHSS scores and the rates of patients with mRS≥3 points at 90 d during hospitalization between the two groups(allP>0.05).Conclusion The clinical efficacy of direct thrombectomy and bridging therapy are similar in wake-up stroke patients with acute anterior circulation large vessel occlusion.

关 键 词：醒后卒中 前循环 机械取栓 桥接治疗 静脉溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]