轻瘫患者慢性大脑中动脉闭塞血管内再通的疗效分析  

Analysis of the efficacy of intravascular recanalization on chronic middle cerebral artery occlusion in patients with mild paresis

作　　者：杨刚[1] 徐吉莉[1] 陈龙雯 黄红星[1] 袁亚辉[1] 赖贤良[2] YANG Gang;XU Jili;CHEN Longwen;HUANG Hongxing;YUAN Yahui;LAI Xianliang(Department of Neurology,Fengcheng People's Hospital,Fengcheng,Jiangxi,331100,China;Department of Neurology,the Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi,330000,China)

机构地区：[1]丰城市人民医院神经内科,江西丰城331100 [2]南昌大学第二附属医院神经外科,江西南昌330000

出　　处：《当代医学》2024年第8期115-119,共5页Contemporary Medicine

基　　金：江西省卫生健康委科技计划(SKJP420203599)。

摘　　要：目的分析轻瘫患者慢性大脑中动脉(MCA)闭塞血管内再通的临床疗效。方法回顾性分析2019年1月至2021年1月南昌大学第二附属医院及丰城市人民医院收治的24例症状性慢性MCA闭塞血管内再通治疗轻瘫患者的临床资料,分析患者的临床资料、血管内再通效果,比较手术前后美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、肌力情况。结果24例症状性慢性MCA闭塞患者中,男17例(70.8%),女7例(29.2%);平均年龄(54.7±8.0)岁;发病至手术时间(36.5±17.3)d。23例患者血管成功再通[改良脑梗死溶栓分级(mTICI)≥2b级]率为95.8%;术后均未发生血管夹层及穿孔、新发脑梗死;发生高灌注综合征2例,其中高灌注引发症状性脑出血1例,头痛1例;术后随访90d未复发缺血性脑卒中/短暂性脑缺血(TIA)。术后90d,患者NIHSS评分低于术前和术后1周,差异有统计学意义(P<0.05);术前与术后1周NIHSS评分比较差异无统计学意义。患者术后90d与术前mRS评分、病变对侧上肢肌力评分比较差异无统计学意义;术后90d,患者病变对侧下肢肌力评分高于术前,差异有统计学意义(P<0.05)。结论血管内再通能降低MCA慢性闭塞轻瘫患者的缺血性脑卒中/TIA复发,并为患肢肌力恢复提供良好的灌注基础。Objective To analyze the clinical efficacy of intravascular recanalization on chronic middle cerebral artery(MCA)occlusion in pa-tients with mail paresis.Methods The clinical data of 24 patients with symptomatic chronic MCA occlusion paresis treated with intravascular re-canalization in mild paralysis admitted to the Second Affiliated Hospital of Nanchang University and the People's Hospital of Fengcheng City from January 2019 to January 2021 were retrospectively analyzed,the clinical data and intravascular recanalization effect were analyzed,and the Nation-al Institutes of Health stroke scale(NIHSS)score,modified Rankin scale(mRS)score,and muscle strength before and after operation were com-pared.Results Among the 24 patients with symptomatic chronic MCA occlusion,there were 17 males(70.8%)and 7 females(29.2%);the average age was(54.7±8.0)years old;the time from onset to surgery was(36.5±17.3)d.The rate of successful revascularization(modified thrombolysis scale for cerebral infarction[mTICI]≥2b)in 23 patients was 95.8%;there was no vascular dissection and perforation,or new cerebral infarction after oper-ation;2 cases of hyperperfusion syndrome occurred,including 1 case of symptomatic cerebral hemorrhage and 1 case of headache caused by hyper-perfusion;there was no recurrence of ischemic stroke/transient ischemic attack(TIA)during 90 d of postoperative follow-up.The score of NIHSS of the patient at 90 d after operation was lower than before operation and 1 week after operation,and the differences were statistically significant(P<0.05);there was no significant difference in NIHSS score between before operation and 1 week after operation.There was no statistically significant difference in mRS scores and muscle strength of the contralateral upper limb scores of patients between the 90 d after operation and before operation;the muscle strength in the contralateral lower limb scores of the patient at 90 d after operation was higher than before operation,and the difference was statistically significant(P<0.05).C

关 键 词：慢性 大脑中动脉闭塞 再通 轻瘫 

分 类 号：R743[医药卫生—神经病学与精神病学]