支架取栓与血栓直接抽吸技术在急性脑动脉闭塞再通中的疗效比较  

Efficacy comparison between stent retriever and a direct aspiration first pass technique for acute ischemic stroke

作　　者：李伟[1] 王清波 马飞飞 郭晖[1] 庞春晓 Li Wei;Wang Qingbo;Ma Feifei;Guo Hui;Pang Chunxiao(Department of Neurosurgery,Interventional Radiology,Weifang People's Hospital,Weijfang 261500,China;Neurosurgery,People's Hospital of Weifang Binhai Economic and Technological Development Zone,Weifang 262737,China;不详)

机构地区：[1]潍坊市人民医院神经外科,山东潍坊261500 [2]潍坊市人民医院介入放射科,山东潍坊261500 [3]潍坊经济开发区人民医院神经外科,山东潍坊262737

出　　处：《中华脑血管病杂志（电子版）》2023年第2期102-106,共5页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：潍坊市科技发展计划项目(2018YX048)。

摘　　要：目的对比分析支架取栓与血栓直接抽吸技术在急性脑动脉闭塞再通中的临床疗效。方法回顾性分析2019年8月至2020年12月在潍坊市人民医院行机械取栓术的40例患者。其中19例患者采用支架取栓(支架取栓组),21例患者采用血栓直接抽吸技术(血栓直接抽吸组)。采用独立样本t检验或Fisher确切概率检验比较2组患者脑动脉再通成功率、手术时间、美国国立卫生研究院卒中量表(NIHSS)评分差值、血栓逃逸发生率、术后脑出血发生率、术后1个月预后良好比例及术后死亡率的差异。结果2组患者心源性因素、脑动脉狭窄、高血压、糖尿病及重大手术后并发症等差异均无统计学意义(P均>0.05)。支架取栓组与血栓直接抽吸组患者脑动脉再通成功率[89.5%(17/19)vs 85.7%(18/21)]、手术时间[(96.8±16.2)min vs(93.0±13.5)min]、NIHSS评分差值(术前-术后)[(5.6±4.6)分vs(5.8±4.1)分]、血栓逃逸发生率[10.5%(2/19)vs 4.8%(1/21)]、术后脑出血发生率[15.8%(3/19)vs 4.8%(1/21)]、术后1个月预后良好比例[52.6%(10/19)vs 47.6%(10/21)]及术后死亡率[26.3%(5/19)vs 14.3%(3/21)]比较,差异均无统计学意义(P=1.00;t=0.828,P=0.413;t=187.5,P=0.752;P=0.596;P=0.331;P=1.000;P=0.442)。结论支架取栓与血栓直接抽吸技术治疗急性脑动脉闭塞均具有较好的临床疗效。Objective To compare the clinical efficacy of the stent retriever with that of the a direct aspiration first pass technique(ADAPT)in the treatment of acute ischemic stroke with cerebral artery occlusions.Methods The clinical data of 40 patients who underwent mechanical thrombectomy in our hospital from Aug 2019 to Dec 2020 were retrospectively selected and divided into two groups.Among them,19 patients were treated with stent retrievers,and the other 21 patients were treated with ADAPT.The success rate of recanalization,operation time,NIHSS score,thrombosis escape rate,postoperative cerebral hemorrhage rate,the proportion of good prognosis at one month after the operation,and postoperative mortality were compared between the two groups.Results There was no significant difference in coronary heart disease,cerebral arterial stenosis,hypertension,diabetes,and major postoperative complication between the two groups(P>0.05).There was no significant difference in the success rate of recanalization[89.5%(17/19)vs 85.7%(18/21)],operation time[(96.8±16.2)min vs(93.0±13.5)min],NIHSS score[(5.6±4.6)score vs(5.8±4.1)score],thrombosis escape rate[10.5%(2/19)vs 4.8%(1/21)],postoperative cerebral hemorrhage rate[15.8%(3/19)vs 4.8%(1/21)],the proportion of good prognosis at one month after operation[52.6%(10/19)vs 47.6%(10/21)],and postoperative mortality[26.3%(5/19)vs 14.3%(3/21)]between the two groups(P=1.00;t=0.828,P=0.413;t=187.5,P=0.752;P=0.596;P=0.331;P=1.000;P=0.442).Conclusion Both the stent retriever and ADAPT have good clinical efficacy in the treatment of acute ischemic stroke with cerebral artery occlusions.

关 键 词：支架取栓 血栓直接抽吸技术 脑动脉再通 

分 类 号：R651.1[医药卫生—外科学]