血管内治疗对于股动脉穿刺至最后清醒时间超24 h急性大血管闭塞的疗效研究  

Effect of endovascular therapy for acute large vessel occlusion with femoral artery puncture to time last known well over 24 hours

作　　者：李卫玲[1] 江毅卿[1] 王恩[1] 洪卫军[1] LI Weiling;JIANG Yiqing;WANG En;HONG Weijun(Department of Neurology,Taizhou Hospital of Zhejiang Province,Taizhou 317000,China)

机构地区：[1]浙江省台州医院神经内科,317000

出　　处：《浙江医学》2023年第11期1178-1181,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020KY1035、2021KY1198)。

摘　　要：目的探讨血管内治疗(EVT)对于股动脉穿刺至最后清醒时间(TLKW)超24 h的急性大血管闭塞(LVO)患者的疗效。方法选择2020年1月至2021年7月浙江省台州医院收治行EVT的24例股动脉穿刺至TLKW超24 h影像失匹配的急性LVO患者为观察组,选择同期股动脉穿刺至TLKW在6 h内的162例急性LVO患者为对照组。比较两组患者术前美国国立卫生研究院卒中量表(NIHSS)评分、前循环LVO、心房颤动、股动脉穿刺至血管再通时间、改良脑梗死溶栓(mTICI)分级2 b/3级、90 d改良Rankin量表(mRS)评分、症状性颅内出血(sICH)和90 d死亡率等情况。结果观察组术前NIHSS评分低于对照组,前循环LVO低于对照组,心房颤动发生率低于对照组,差异均有统计学意义(均P<0.05)。两组患者股动脉穿刺至血管再通时间、mTICI分级2b/3、90 d mRS评分0~2分、sICH及90 d死亡率比较,差异均无统计学意义(均P>0.05)。结论EVT对于股动脉穿刺至TLKW超24 h影像失匹配的急性LVO患者可能有益。Objective To investigate the efficacy of endovascular therapy(EVT)for acute large vessel occlusion(LVO)patients with femoral artery puncture to time last known well(TLKW)over 24 hours.Methods Twenty-four patients with acute LVO and mismatched images of femoral artery puncture to TLKW exceeding 24 h who underwent EVT in Taizhou Hospital of Zhejiang Province from January 2020 to July 2021 were enrolled in the study(observation group)and 162 LVO patients with femoral artery puncture to TLKW within 6 hours were selected as the control group.The National Institutes of Health stroke scale(NIHSS),anterior circulation LVO,atrial fibrillation,femoral artery puncture to vessel revascularization time,modified thrombolysis in cerebral infarction(mTICI)grade 2b/3,90 d modified Rankin scale(mRS)score,symptomatic intracranial hemorrhage(sICH)and 90d mortality were compared between the two groups.Results The preoperative NIHSS score in the study group was lower than that in the control group;the anterior circulation LVO and the incidence of atrial fibrillation of the study group was lower than those of the control group(all P<0.05).There was no significant difference in the time from femoral artery puncture to vascular recanalization between the two groups(P>0.05).There were no significant differences in mTICI grade 2b/3 and mRS scores 0-2 at 90 d after EVT between two groups(all P>0.05).There were no significant differences in sICH and 90 d mortality after EVT between two groups(all P>0.05).Conclusion EVT may be beneficial for acute LVO patients with mismatched images and femoral artery puncture to TLKW exceeding 24 h.

关 键 词：血管内治疗 急性大血管闭塞 缺血半暗带 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]