Solitaire支架联合Navien颅内支撑导管治疗急性缺血性脑卒中的效果及预后影响因素分析  

Solitaire stent combined with Navien intracranial support catheter in the treatment of acute ischemic stroke and analysis of prognostic factors

作　　者：李亮[1] 张继伟[1] 孙文浩[1] 王广[1] 田甜[1] 于淼[1] Li Liang;Zhang Jiwei;Sun Wenhao;Wang Guang;Tian Tian;Yu Miao(Department of Neurosurgery,the Affiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)

机构地区：[1]承德医学院附属医院神经外科,河北承德067000

出　　处：《血管与腔内血管外科杂志》2021年第9期1074-1078,共5页Journal of Vascular and Endovascular Surgery

基　　金：承德市科学技术研究与发展计划项目(201804A031)。

摘　　要：目的探讨Solitaire支架联合Navien颅内支撑导管治疗急性缺血性脑卒中的效果及预后影响因素。方法收集2017年1月至2020年12月在承德医学院附属医院接受治疗的120例急性缺血性脑卒中患者的临床资料。根据术后3个月的预后情况分为预后良好组(n=97)和预后不良组(n=23)。统计120例患者术后即刻和术后2周血管再通率;预后不良的影响因素分析采用Logistic回归分析。结果120例患者,术后即刻再通率为100%,术后2周再通率为95.83%。经Logistic回归分析显示,合并高血压、合并糖尿病、合并心房颤动、合并颈内动脉闭塞、术后存在症状性脑出血、发病至入院时间长、入院时Alberta卒中项目早期计算机断层扫描评分(pc-ASPECTS)低、术前美国国立卫生院神经功能缺损评分(NIHSS)高、取栓次数多为影响急性缺血性脑卒中患者预后不良的独立危险因素(P<0.05)。结论Solitaire支架联合Navien颅内支撑导管治疗有利于提高血管再通率。合并高血压、糖尿病、心房颤动、颈内动脉闭塞、术后存在症状性脑出血、发病至入院时间长、入院时pc-ASPECTS评分低、NIHSS评分高及取栓次数多为急性缺血性脑卒中患者预后不良的危险因素。Objective To explore the effect of Solitaire stent combined with Navien intracranial support catheter in the treatment of acute ischemic stroke and analyze the prognostic factors.Method The clinical data of 120 patients with acute ischemic stroke admitted in the Affiliated Hospital of Chengde Medical College from January 2017 to December 2020 were collected,and the patients were divided into the good prognosis group(n=97)and poor prognosis group(n=23)based on prognosis 3 months after surgery.The recanalization rate was calculated right after and 2 months after surgery;the influencing factors of poor prognosis was analyzed by Logistic regression.Result The recanalization rate was 100.00%right after surgery and 95.83%after surgery 2 weeks.The Logistic regression showed that concomitant hypertension,diabetes,atrial fibrillation(AF),internal carotid artery occlusion(ICA),symptomatic cerebral hemorrhage,long time from onset to hospital admission,lower scores of posterior circulation Alberta stroke program early computed tomography(pc-ASPECTS)at admission,higher scores of National Institutes of Health Neurological Deficit score(NIHSS)before surgery and number of thrombus removal were independent risk factors influencing prognosis of patients with acute ischemic stroke(P<0.05).Conclusion Solitaire stent combined with Navien intracranial support catheter is beneficial to the rate of vascular recanalization.Concomitant hypertension,diabetes,AF,ICA,symptomatic cerebral hemorrhage,long time from onset to hospital admission,lower scores of pc-ASPECTS at admission,higher scores of NIHSS before surgery and number of thrombus removal are independent risk factors influencing prognosis of patients with acute ischemic stroke.

关 键 词：Solitaire支架 Navien颅内支撑导管 急性缺血性脑卒中 预后 

分 类 号：R543[医药卫生—心血管疾病]