直接抽吸与支架取栓对大脑中动脉闭塞性急性缺血性脑卒中患者治疗效果的比较  

Therapeutic effect of direct aspiration versus stent-retriever thrombectomy in patients with acute ischemic stroke due to middle cerebral artery occlusion

作　　者：袁磊[1] 赵晓玲[1] 张举孔[1] 王明[1] 刘洋[1] YUAN Lei;ZHAO Xiaoling;ZHANG Jukong;WANG Ming;LIU Yang(Department of Neurology,The Second People’s Hospital of Nanyang City,Nanyang 473000,China)

机构地区：[1]南阳市第二人民医院神经内科,河南南阳473000

出　　处：《精准医学杂志》2024年第6期535-537,542,共4页Journal of Precision Medicine

基　　金：南阳市科技发展计划项目(KJGG126)。

摘　　要：目的对比直接抽吸和支架取栓对于大脑中动脉闭塞性急性缺血性脑卒中(acute ischemic stroke,AIS)患者的治疗效果。方法选取我院2018年1月—2021年12月行血管内取栓的大脑中动脉闭塞性AIS患者59例,根据取栓方式的不同分为抽吸取栓组(25例)和支架取栓组(34例),收集并比较两组患者的基本资料、术后血管再通率、穿刺到血管再通时间、术前NHISS评分、术前术后即刻NHISS评分差值(△1 NHISS评分)、术前术后24 h NHISS评分差值(△2 NHISS评分)、血栓逃逸率、实施补救率、术后7 d颅内出血率、术后7 d病死率及术后90 d预后良好率。结果抽吸取栓组患者穿刺到血管再通时间显著短于支架取栓组(t=5.923,P<0.05),两组患者血管再通率、△1 NHISS评分、△2 NHISS评分、血栓逃逸率、实施补救率、术后7 d颅内出血率、术后7 d病死率及术后90 d预后良好率均无显著差异(P>0.05)。结论直接抽吸与支架取栓两种手术方式治疗大脑中动脉闭塞性AIS均效果良好,两种术式患者的血管再通率、神经功能恢复程度及预后相似,但抽吸取栓手术方式的血管再通耗时更短。Objective To compare the therapeutic effects of direct aspiration and stent-retriever thrombectomy in patients with acute ischemic stroke(AIS)due to middle cerebral artery occlusion.Methods We included 59 patients with AIS due to middle cerebral artery occlusion who underwent endovascular thrombectomy in our hospital from January 2018 to December 2021.Among them,25 cases underwent direct aspiration for thrombectomy,and 34 cases underwent stent-retriever thrombectomy.The two groups were compared in terms of basic data,successful recanalization rate,puncture-to-recanalization time,National Institutes of Health Stroke Scale(NIHSS)score before operation,change in NIHSS score immediately after operation(△1 NIHSS score),change in NIHSS score at 24 h after operation(△2 NIHSS score),the rate of thrombus escape,the rate of rescue treatment,the rate of intracranial hemorrhage at 7 d after operation,the mortality rate at 7 d after operation,and the percentage of patients with good prognosis at 90 d after operation.Results The time from puncture to successful recanalization was significantly shorter in the aspiration group than in the stent retriever group(t=5.923,P<0.05).There were no significant between-group differences in the recanalization rate,the△1 NIHSS score,the△2 NIHSS score,the rate of thrombus escape,the rate of rescue treatment,the rate of intracranial hemorrhage at 7 d after operation,the mortality rate at 7 d after operation,and the percentage of patients with good prognosis at 90 d after operation(P>0.05).Conclusion Both direct aspiration and stent-retriever thrombectomy have good effectiveness for the treatment of AIS due to middle cerebral artery occlusion,with similar vascular recanalization rate,neurological recovery degree,and prognosis,but direct aspiration can shorten the time from puncture to recanalization.

关 键 词：梗死 大脑中动脉 缺血性卒中 血管内操作 机械溶栓 疗效比较研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]