导管抽吸取栓术与支架取栓术治疗急性后循环大血管闭塞性脑梗死的疗效比较  

Comparison of efficacies between catheter aspiration thrombectomy and stent thrombectomy in the treatment of acute cerebral infarction with posterior circulation large vessel occlusion

作　　者：韦韬[1] 高文[1] 覃彬 WEI Tao;GAO Wen;QIN Bin(Department of Neurology,Liuzhou People’s Hospital,Guangxi,Liuzhou 545006,China)

机构地区：[1]广西壮族自治区柳州市人民医院神经内科,广西柳州545006

出　　处：《中国医药科学》2024年第10期149-152,共4页China Medicine And Pharmacy

基　　金：广西卫生健康委员会科研课题(Z20200225);广西壮族自治区柳州市科技局科技重大专项课题(2018AF10502)。

摘　　要：目的 评估导管抽吸取栓术和支架取栓术应用于后循环大血管闭塞性脑梗死的有效性及安全性。方法 回顾性分析2020年1月至2022年5月于柳州市人民医院神经内科接受血管内治疗的急性后循环大血管闭塞性脑梗死患者。分析其临床资料、治疗效果、术后并发症及临床预后。采用改良脑梗死溶栓治疗(mTICI)、美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(mRS)分别评价患者手术再通成功与否及临床预后。结果 共有75例患者纳入分析,其中46例患者首选导管抽吸取栓治疗,29例首选支架栓治疗。导管抽吸取栓组完全再通成功率(mTICI 3级)略高于支架取栓组(73.91%vs. 62.07%),但差异无统计学意义(P> 0.05)。导管抽吸取栓组和支架取栓组患者的成功再通率(mTICI 2b/3级)、术后7 d NIHSS评分、术后90 d良好功能预后(mRS≤2分)及住院期间病死率比较,差异无统计学意义(P> 0.05)。导管抽吸取栓组患者脑出血、血管夹层形成及血栓逃逸的发生略低于支架取栓组,但差异无统计学意义(P> 0.05)。结论 导管抽吸取栓和支架取栓治疗急性后循环大血管闭塞性脑梗死的临床疗效相当,安全性相似,均有助于疏通闭塞血管、改善患者预后生存结局。Objective To evaluate the effectiveness and safety of catheter aspiration thrombectomy and stent thrombectomy in the treatment of cerebral infarction with posterior circulation large vessel occlusion.Methods The patients with acute cerebral infarction with posterior circulation large vessel occlusion who received endovascular treatment in Department of Neurology of Liuzhou People’s Hospital from January 2020 to May 2022 were retrospectively analyzed.The clinical data,therapeutic efficacy,postoperative complications and clinical prognosis were analyzed.The modified treatment in cerebral infarction(mTICI),National Institute of Health stroke scale(NIHSS)and modified Rankin scale(mRS)were used to evaluate the success of surgical recanalization and clinical prognosis,respectively.Results A total of 75 patients were included in the analysis,of which 46 patients preferred to be treated with catheter aspiration thrombectomy and 29 patients preferred to be treated with stent thrombectomy.The complete recanalization success(mTICI grade 3)in the catheter aspiration thrombectomy group was 73.91%,slightly higher than 62.07%in the stent thrombectomy group,but without statistically significant differences(P>0.05).There were no statistically significant differences in successful recanalization(mTICI grade 2b/3),NIHSS score at 7 days after operation,good functional prognosis at 90 days after operation(mRS≤2 points)and in-hospital mortality between the catheter aspiration thrombectomy group and the stent thrombectomy group(P>0.05).The incidences of cerebral hemorrhage,vascular dissection and thrombus escape in the catheter aspiration thrombectomy group were slightly lower than those in the stent thrombectomy group,but without statistically significant differences(P>0.05).Conclusion The clinical efficacy and safety of catheter aspiration thrombectomy and stent thrombectomy are similar in the treatment of acute cerebral infarction with posterior circulation large vessel occlusion,which are both conducive to dredging occluded bl

关 键 词：导管抽吸取栓术 支架取栓术 急性后循环闭塞 脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]