替罗非班治疗颅内动脉瘤栓塞术中急性血栓的疗效  

Treatment of acute thrombosis during intracranial arterial embolization by tirofiban

作　　者：凌国源 莫立根[1] 林雄[2] 蒋骞 温粮宝 石柳[1] Ling Guoyuan;Mo Ligen;Lin Xiong;Jiang Qian;Wen Liangbao;Shi Liu(Department of Neurosurgery,Affiliated Tumor Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China;Department of Neurosurgery,Baise People's Hospital,Baise 533000,Guangxi,China)

机构地区：[1]广西医科大学附属肿瘤医院神经外科,广西南宁530021 [2]百色市人民医院神经外科,广西百色533000

出　　处：《血管与腔内血管外科杂志》2023年第2期154-158,共5页Journal of Vascular and Endovascular Surgery

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2020097)。

摘　　要：目的探讨替罗非班治疗颅内动脉瘤栓塞术中急性血栓的疗效。方法收集2016年6月至2020年6月于广西医科大学附属肿瘤医院及广西百色市人民医院就诊的425例颅内动脉瘤患者的临床资料,其中,25例颅内动脉瘤术中发生急性血栓,按照术中是否使用支架将其分为支架组(n=16)与非支架组(n=9),两组患者均应用替罗非班进行治疗,比较两组患者血管再通情况、并发症发生情况、预后情况及改良Rankin量表(mRS)评分。结果两组患者血管再通时间分别为(37.2±4.7)、(34.9±4.8)min,成功再通率均为100%,两组患者血管再通时间、成功再通率比较,差异均无统计学意义(P﹥0.05)。支架组患者术后并发症总发生率为25.00%(4/16),与非支架组的11.11%(1/9)比较,差异无统计学意义(P﹥0.05)。术后6个月24例患者完成随访,支架组预后良好率为86.67%(13/15),与非支架组的88.89%(8/9)比较,差异无统计学意义(P﹥0.05)。结论应用替罗非班治疗颅内动脉瘤栓塞术中急性血栓安全、有效,术中可根据患者具体情况结合中间导管负压持续抽吸血栓或微导管、微导丝机械碎栓。Objective To investigate the safety and efficacy of tirofiban in the treatment of acute thrombosis during intracranial arterial embolization.Method The data of 425 patients with intracranial aneurysms who underwent interventional embolization from June 2016 to June 2020 were retrospectively analyzed.The data of 25 patients with acute thrombosis during intracranial were included in the study,they were divided into stent group(n=16)and non stent group(n=9),and all treated with tirofiban.The recanalization,complications and follow-up modified Rankin scale(mRS)scores of the two groups were compared.Result The vascular recanalization time was(37.2±4.7)and(34.9±4.8)min respectively in the two groups,the successful recanalization rates of two groups were all 100%,there were no statistically significant difference in the postoperative recanalization time and successful recanalization rates between the two groups(P>0.05).The total incidence of postoperative complications in the stent group was 25.00%(4/16),which was not significantly different from 11.11%(1/9)in the non stent group(P>0.05).Six months after surgery,24 patients completed follow-up,the good prognosis rate in the stent group was 81.25%(13/16),compared with 88.89%(8/9)in the non stent group,the difference was not statistically significant(P>0.05).Conclusion Tirofiban is safe and effective in the treatment of acute thrombosis during intracranial aneurysm embolization.

关 键 词：替罗非班 颅内动脉瘤 血栓 

分 类 号：R543[医药卫生—心血管疾病]