手动抽吸取栓术在急性脑动脉闭塞治疗中的临床应用效果研究  

Study on clinical effect of manual aspiration thrombectomy in the treatment of acute cerebral artery occlusion

作　　者：刘根 陈钜涛 伍振富[1] 叶杰明[1] 赖穗翩[1] 黎冠东[1] LIU Gen;CHEN Ju-tao;WU Zhen-fu(Department of Neurology,Jiangmen Central Hospital,Jiangmen 529000,China)

机构地区：[1]江门市中心医院神经内科,529000

出　　处：《中国现代药物应用》2024年第10期41-44,共4页Chinese Journal of Modern Drug Application

摘　　要：目的观察手动抽吸取栓术(MAT)在急性脑动脉闭塞治疗中的可行性、安全性及临床疗效。方法选择急性脑动脉闭塞首次采用MAT技术治疗的患者27例,其中行MAT的患者共19例,作为MAT组;行MAT联合支架取栓治疗的患者共8例,作为MAT+支架组。记录两组患者性别、年龄、吸烟、高血压、糖尿病、心房颤动、高脂血症、冠心病、风湿性心脏病、静脉溶栓、取栓部位、穿刺至再通时间、血管再通标准(mTICI)分级、血栓逃逸、脑出血、术前美国国立卫生研究院卒中量表(NIHSS)评分、术后7 d NIHSS评分、90 d改良Rankin评分量表(mRS)评分≤2分、死亡情况。结果27例患者首次进行MAT,男性16例(59.3%),女性(40.7%);年龄(67.2±11.5)岁;静脉溶栓有9例(33.3%);取栓部位为颈内动脉有5例(18.5%),大脑中动脉有18例(66.7%),基底动脉有3例(11.1%),大脑后动脉有1例(3.7%);穿刺至再通时间为65(48,90)min。有26例(96.3%)患者实现血管再通。mTICI分级为2b级有12例(44.4%),3级有14例(51.9%);血栓逃逸有5例(18.5%);症状性脑出血有2例(7.4%),无症状脑出血有1例(3.7%);术前NIHSS评分为(13.9±3.8)分,术后7 d NIHSS评分为(8.4±6.6)分,术后7 d NIHSS评分低于术前(P<0.05);90 d mRS评分≤2分有14例(51.9%);死亡3例(11.1%),其中2例是取栓后出现症状性脑出血导致,1例是因为肺动脉栓塞导致的。结论MAT在急性脑动脉闭塞中治疗是可行、安全及有效的。Objective To observe the feasibility,safety and clinical efficacy of manual aspiration thrombectomy(MAT)in the treatment of acute cerebral artery occlusion.Methods Among 27 patients with acute artery occlusion treated with MAT for the first time,19 patients undergoing MAT were selected as MAT group and 8 patients who underwent MAT combined with stent thrombectomy as MAT+stent group.The gender,age,smoking,hypertension,diabetes,atrial fibrillation,hyperlipidemia,coronary heart disease,rheumatic heart disease,intravenous thrombolysis,site of thrombolysis,time from puncture to revasculation,modified thrombolysis in cerebral infarction(mTICI)grading,thrombus escape,cerebral hemorrhage,National Institutes of Health Stroke Scale(NIHSS)score before surgery,and NIHSS score 7 d after surgery,90-d modified Rankin scale(mRS)score≤2 points,and death were recorded in both groups.Results 27 patients underwent MAT for the first time,of which 16 cases(59.3%)were males and 40.7%were females,at(67.2±11.5)years of age;intravenous thrombolysis occurred in 9 cases(33.3%).thrombectomy sites were internal carotid artery in 5 cases(18.5%),middle cerebral artery in 18 cases(66.7%),basilar artery in 3 cases(11.1%),and posterior cerebral artery in 1 case(3.7%).The time from puncture to recanalization was 65(48,90)min.Vascular recanalization was achieved in 26 patients(96.3%).There were 12 cases(44.4%)with mTICI grade 2b and 14 cases(51.9%)with MTICI grade 3.Thrombus escape occurred in 5 cases(18.5%).Symptomatic intracerebral hemorrhage occurred in 2 cases(7.4%)and asymptomatic intracerebral hemorrhage occurred in 1 case(3.7%).The NIHSS score was(13.9±3.8)points before surgery,and(8.4±6.6)points at 7 d after surgery;NIHSS score at 7 d after surgery was lower than that before surgery(P<0.05).There were 14 cases(51.9%)with 90 d mRS score≤2 points;3 cases(11.1%)died,of which 2 cases were caused by symptomatic cerebral hemorrhage after thrombus extraction,and 1 case was caused by pulmonary embolism.Conclusion MAT is feasible,safe and effe

关 键 词：手动抽吸取栓术 急性脑动脉闭塞 急性缺血性脑卒中 临床疗效 安全性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]