不同取栓方式治疗急性大脑中动脉M2段闭塞性脑梗死的疗效及安全性  

Efficacy and safety analysis of different thrombectomy techniques for the treatment of acute M2 segment occlusive cerebral infarction

作　　者：彭潇[1] 蔡学礼[1] 黄逸杰 李威 邬至平[1] 黄良通[1] 金哲宇 PENG Xiao;CAI Xueli;HUANG Yijie;LI Wei;WU Zhiping;HUANG Liangtong;JIN Zheyu(Department of Neurology,Lishui Central Hospital,Lishui Clinical Research Center for Neurological Diseases,Lishui 323000,China)

机构地区：[1]丽水市中心医院神经内科、丽水市神经病学临床研究中心,浙江丽水323000

出　　处：《温州医科大学学报》2023年第10期795-800,共6页Journal of Wenzhou Medical University

基　　金：中国脑卒中高危人群干预适宜技术研究及推广项目(GN-2020R0009);丽水市重点研发计划项目(2023zdyf17);浙江省高层次创新型卫生人才培养计划。

摘　　要：目的:探讨不同取栓方式用于治疗急性大脑中动脉M2段闭塞性脑梗死的疗效及安全性。方法:回顾性分析2018年8月至2022年10月丽水市中心医院接受机械取栓治疗的45例大脑中动脉M2段闭塞性脑梗死患者临床资料,分为直接抽吸组和抽吸结合支架取栓组(简称联合组),分析两组取栓次数、血管再通时间、治疗有效率、良好预后率的差异。结果:联合组平均股动脉穿刺-再通时间为(61.7±17.4)min,比直接抽吸组的(71.3±24.2)min短,差异有统计学意义(P=0.037);联合组取栓次数少于直接抽吸组,差异有统计学意义[1.0(1.0,2.0)vs.2.0(1.0,4.0),P=0.034];联合组治疗有效率为77.8%,直接抽吸组为55.6%;联合组良好预后率为70.4%,直接抽吸组为44.4%。结论:急性大脑中动脉M2段闭塞性脑梗死患者,抽吸联合支架取栓术与直接抽吸取栓术相比,再通时间更短,有效率及良好预后率可能更高。Objective:To investigate the efficacy and safety of different embolization techniques in the treatment of acute middle cerebral artery M2 segment occlusive cerebral infarction.Methods:A retrospective analysis was conducted on the clinical data of 45 patients with occlusive M2 segment cerebral infarction who received mechanical thrombectomy treatment at Lishui Central Hospital from August 2018 to October 2022.The patients were divided into a direct aspiration thrombectomy group and an aspiration thrombectomy combined with stent implantation group(referred to as the combined group),and the differences in the number of thrombectomies,vascular recanalization time,treatment effectiveness,and good prognosis rate between the two groups were analyzed.Results:The average arterial puncture-recanalization time was shorter in the combined group than in the direct aspiration group[(61.7±17.4)min vs.(71.3±24.2)min,P=0.037],and the difference was statistically significant;the number of embolizations in the combined group was less than that in the direct aspiration group[1.0(1.0,2.0)vs.2.0(1.0,4.0),P=0.034],and the difference was significant difference;the efficiency of the combined group was better than that of the aspiration group(77.8%vs.55.6%);the good prognosis rate of the combined group was better than that of the aspiration group(70.4%vs.44.4%).Conclusion:Compared with direct aspiration thrombectomy,the combined technique of aspiration and stent implantation has a shorter time to revascularization and perhaps higher efficacy and favorable prognosis for acute M2 segment occlusion in the middle cerebral artery.

关 键 词：大脑中动脉M2段闭塞 脑梗死 血管内治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]