合并大血管闭塞的超时间窗前循环进展性脑卒中血管内治疗的有效性与安全性评价  

Efficacy and safety evaluation of endovascular treatment for progressive stroke with overtime window anterior circulation combined with large vascular occlusion

作　　者：霍富元 卢奎[1] HUO Fuyuan;LU Kui(Department of Internal Medicine Neurology,Zhongshan City People’s Hospital,Guangdong,Zhongshan 528403,China)

机构地区：[1]广东省中山市人民医院神经内科,广东中山528403

出　　处：《中国医药科学》2023年第11期17-20,25,共5页China Medicine And Pharmacy

基　　金：广东省中山市医学科研项目(2021A020608)。

摘　　要：目的探讨合并大血管闭塞的超时间窗前循环进展性脑卒中血管内治疗的有效性与安全性。方法回顾性选取2019年12月至2021年12月中山市人民医院收治的经RAPID软件评估适合血管内治疗的前循环进展性脑卒中患者133例,按照治疗方法不同分为血管内治疗组与药物治疗组,其中血管内治疗组66例,药物治疗组70例。血管内治疗组予以支架取栓、血栓抽吸等实现血管再通,药物治疗组采用常规治疗;观察治疗前及治疗后1、7、14 d美国国立卫生研究院卒中量表(NIHSS)评分,90 d改良Rankin评分量表(mRS)评分,症状性颅内出血率。结果血管内治疗组治疗后1、7、14 d NIHSS评分与药物治疗组比较,差异有统计学意义(P<0.05);治疗14 d后总有效率血管内治疗组(57.575%)较药物治疗组(17.142%)明显提高,差异有统计学意义(P<0.05);90 d预后良好率血管内治疗组为48.484%,药物治疗组为14.285%,差异有统计学意义(P<0.05);两组间症状性颅内出血率比较,差异无统计学意义(P>0.05)。结论严格筛选合并大血管闭塞的超时间窗前循环进展性脑卒中进行血管内治疗可获得良好的临床效果,症状性颅内出血无明显增加。Objective To investigate the efficacy and safety of endovascular treatment for progressive stroke with overtime window anterior circulation combined with large vascular occlusion.Methods A total of 133 patients with progressive stroke with anterior circulation,which was evaluated by RAP ID software as suitable for endovascular treatment,and admitted to and treated in Zhongshan City People’s Hospital from December 2019 to December 2021 were retrospectively included.According to different treatment methods,they were divided into the endovascular treatment group(n=66)and the medication group(n=70).The endovascular treatment group was treated with stent removal and thrombus aspiration,etc.,to realize vascular recanalization,while the medication group was treated with conventional therapy.The National Institute of Health Stroke Scale(NIHSS)scores,the 90-day Modified Rankin Scale(mRS)scores and the symptomatic intracranial hemorrhage rate were observed before treatment and 1 day,7 days and 14 days after treatment.Results There were statistically significant differences in NIHSS scores between the endovascular treatment group and the medication group 1 day,7 days and 14 days after treatment(P<0.05).On the 14th day after treatment,the overall response rate in the endovascular treatment group was 57.575%,remarkably higher than 17.142%in the medication group,with statistically significant difference(P<0.05).On the 90th day after treatment,the good prognosis rate in the endovascular treatment was 48.484%,while that in the medication group was 14.285%,with statistically significant difference(P<0.05).There was no statistically significant difference in the symptomatic intracranial hemorrhage rate between the two groups(P>0.05).Conclusion Strict screening of progressive stroke with overtime window anterior circulation combined with large vascular occlusion for endovascular treatment can achieve good clinical efficacies,and there is no significant i ncrease in symptomatic intracranial hemorrhage.

关 键 词：RAPID软件 超时间窗 进展性脑卒中 血管内治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]