Solumbra技术和SWIM技术治疗脑卒中的疗效对比  

Comparison of efficacy between Solumbra technique and SWIM technique for stroke

作　　者：戚佳敏 吴剑红 王俊[1] 董国丽 Qi Jiamin;Wu Jianhong;Wang Jun;Dong Guoli(Department of Neurosurgery,Linping Campus,The Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou,Zhejiang 311100,China)

机构地区：[1]浙江大学医学院附属第二医院临平院区神经外科,浙江杭州311100

出　　处：《中国微侵袭神经外科杂志》2024年第7期404-408,共5页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：浙江省医药卫生科技计划项目(编号:2020KY800)。

摘　　要：目的评估Solumbra技术和SWIM技术治疗急性缺血性脑卒中(acute ischemic stroke,AIS)的有效性与安全性。方法回顾性分析191例AIS病例资料,根据手术方式分为Solumbra组(n=97)和SWIM组(n=94)。应用倾向性评分匹配法(propensity score matching,PSM)将两组患者按1∶1配比。对比匹配后两组患者临床相关指标、术后不同时间点美国国立卫生院卒中量表(the National Institutes of Health Stroke Scale,NIHSS)评分、侧支循环改善情况及并发症发生率。结果经PSM匹配,有50对患者匹配成功。Solumbra组患者取栓>2次占比与住院时间均高于SWIM组,预后良好占比低于SWIM组(P<0.05)。Solumbra组患者术后7d及术后2周NIHSS评分均低于SWIM组(P<0.05)。并发症发生率Solumbra组为20.00%,SWIM组为38.00%,Solumbra组低于SWIM组(P<0.05)。结论Solumbra技术和SWIM技术取栓治疗各有优势,临床可充分结合患者实际病情,针对性选择取栓方式。Objective To evaluate the effectiveness and safety of Solumbra technique and SWIM technique in the treatment of acute ischemic stroke(AIS).Methods Clinical data of 191 patients with AIS,which were divided into the Solumbra group(n=97)and the SWIM group(n=94)based on the surgical approach,were analyzed retrospectively.Propensity score matching(PSM)was applied to match patients in a 1:1 ratio between the two groups.Clinical parameters,National Institutes of Health Stroke Scale(NIHSS)scores at different time points postoperatively,improvement in collateral circulation,and complication rates were compared between the two matched groups.Results After PSM,50 pairs of patients were successfully matched.The Solumbra group had a higher proportion of patients requiring more than 2 thrombectomies and longer hospital stays compared to the SWIM group,with a lower proportion of good outcomes(P<0.05).The NIHSS scores at 7 days and 2 weeks postoperatively were lower in the Solumbra group than in the SWIM group(P<0.05).The complication rate was 20.00%in the Solumbra group and 38.00%in the SWIM group,indicating a lower complication rate in the Solumbra group(P<0.05).Conclusions Both Solumbra technique and SWIM technique have their respective advantages in the treatment of AIS with endovascular thrombectomy.Clinical decisions should be made based on the individual patient's condition to select the most appropriate thrombectomy approach.

关 键 词：缺血性脑卒中 急性 倾向性评分匹配法 Solumbra技术 SWIM技术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]