血管内治疗不同分期动脉粥样硬化性椎基底动脉闭塞性脑梗死  

Endovascular treatment of atherosclerotic vertebrobasilar occlusive cerebral infarction in different phases

作　　者：李水仙[1] 陈星宇[1] 阳清伟[1] 陈中杰[1] 陈良义[1] 王显锏[1] 葛华[1] 吴雁 金首跃 朱仁敬[1] LI Shuixian;CHEN Xingyu;YANG Qingwei;CHEN Zhongjie;CHEN Liangyi;WANG Xianjian;GE Hua;WU Yan;JIN Shouyue;ZHU Renjing(Department of Neurology,Zhongshan Hospital of Xiamen University,Xiamen 361004,China)

机构地区：[1]厦门大学附属中山医院(福建医科大学临床医学部)神经内科,福建厦门361004

出　　处：《中国介入影像与治疗学》2022年第9期529-533,共5页Chinese Journal of Interventional Imaging and Therapy

基　　金：厦门市科技计划指导性项目(3502Z20209036)。

摘　　要：目的观察血管内治疗不同分期动脉粥样硬化性椎基底动脉闭塞性脑梗死(ASVBOCI)的效果。方法回顾性分析77例接受血管内治疗的ASVBOCI患者,包括急性期组(发病≤24 h,AP组)23例、亚急性早期组(发病>24 h且≤14 d,SAEP组)23例、亚急性晚期及慢性期组(发病>14 d,SALCP组)31例,对比观察3组术中情况、围手术期不良事件及预后。结果AP组、SAEP组及SALCP组血管再通率分别为78.26%(18/23)、95.65%(22/23)及93.55%(29/31),差异无统计学意义(P>0.05);AP组、SAEP组术中机械取栓率均高于SALCP组(P均<0.05),AP组球囊扩张及支架植入均低于SAEP组和SALCP组(P均<0.05)。围手术期AP组1例、SAEP组2例颅内出血,SALCP组无出血。术后3个月SALCP组预后良好率高于、死亡率低于AP组及SAEP组(P均<0.05),后二者差异均无统计学意义(P均>0.05)。结论血管内治疗不同分期ASVBOCI安全、有效。Objective To observe the effect of endovascular treatment for atherosclerotic vertebrobasilar occlusive cerebral infarction(ASVBOCI).Methods Totally 77 patients with ASVBOCI who underwent endovascular treatments,including 23 cases in acute phase(AP group,onset≤24 h),23 in subacute early phase(SAEP group,onset>24 h and≤14 d)and 31 cases in subacute late phase and chronic phase(SALCP group,onset>14 d)were retrospectively analyzed.The intraoperative situations,perioperative adverse events and prognosis were compared among 3 groups.Results The vascular recalculation rate of AP,SAEP and SALCP groups was 78.26%(18/23),95.65%(22/23)and 93.55%(29/31),respectively,with no siqnificant difference(P>0.05).The intraoperative rate of mechanical thrombectomy in AP and SAEP groups were higher than that in SALCP group(both P<0.05),and balloon expansion and stent implantation in AP group was lower than those in SAEP group and SALCP group(all P<0.05).Intracranial hemorrhage occurred in 1 case of AP group and 2 cases of SAEP group,but not in SALCP group.Three months after treatments,the good prognosis rate of SALCP group was higher,and the mortality rate was lower than that of AP group and SAEP group(all P<0.05),while no siqnificant difference was found between AP group and SAEP group(both P>0.05).Conclusion Endovascular treatment was safe and effective for different phases ASVBOCI.

关 键 词：脑梗死 基底动脉 椎动脉 动脉粥样硬化 血管内治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R815[医药卫生—临床医学]