3D-DSA路图引导下血管再通术对不同分型颅内动脉非急性闭塞患者的治疗效果及预后分析  

Therapeutic Effect and Prognosis Analysis of 3D-DSA Roadmap Guided Vascular Recanalization in Patients with Different Types of Non-acute Intracranial Artery Occlusion

作　　者：李茂港 刘翰文 LI Maogang;LIU Hanwen(Department of Neurosurgery,Ganzhou Municipal Hospital,Ganzhou 341000,China;不详)

机构地区：[1]赣州市立医院神经外科,江西赣州341000

出　　处：《中国医学创新》2024年第28期35-39,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(SKJP220210552)。

摘　　要：目的:分析3D数字减影血管造影(3D-DSA)路图引导下血管再通术对不同分型颅内动脉非急性闭塞患者的治疗效果及预后影响。方法:回顾性选取2020年6月—2023年6月赣州市立医院神经外科收治的60例采用3D-DSA路图引导下血管再通术治疗的颅内动脉非急性闭塞患者临床资料,基于闭塞时间、长度及侧支循环特征,将颅内动脉闭塞分为3型(颅动脉闭塞Ⅰ型21例,Ⅱ型25例,Ⅲ型14例),评价不同闭塞分型患者血管再通情况[脑梗死溶栓(TICI)评估系统],术前、术后美国国立卫生研究院卒中量表(NIHSS)评分和改良Rankin量表(mRS)评分,术后30 d内并发症、卒中及手术相关死亡情况。结果:三种分型患者的合并高血压、卒中史、术前病情诊断比例差异均有统计学意义(P<0.05),性别、年龄、合并糖尿病、高血脂和冠心病、术前NIHSS评分≤3分和mRS评分≤2分比例等差异均无统计学意义(P>0.05);60例患者血管再通成功率为95.00%,三种分型患者比较差异无统计学意义(P>0.05);术后30 d,三种分型患者NIHSS评分和mRS评分均较术前显著降低(P<0.05),且Ⅰ型、Ⅱ型患者NIHSS评分和mRS评分均显著低于Ⅲ型患者(P<0.05);术后30 d内,60例患者并发症总发生率为6.67%,三种分型间差异无统计学意义(P>0.05);术后30 d内,Ⅱ型患者和Ⅲ型患者各有1例出血性卒中,无缺血性卒中及手术相关死亡情况发生,三种分型间差异均无统计学意义(P>0.05)。结论:3D-DSA路图引导下血管再通术可用于治疗不同分型颅内动脉非急性闭塞患者,术后并发症少,安全性和可行性较高,具有潜在治疗收益。Objective:To analyze the therapeutic effect of 3D digital subtraction angiography(3D-DSA)-guided roadmap vascular recanalization in patients with different types of non-acute intracranial artery occlusion and its influence on prognosis.Method:The clinical data of 60 patients with non-acute intracranial artery occlusion who underwent 3D-DSA roadmap-guided vascular recanalization from June 2020 to June 2023 were retrospectively selected in Neurosurgery Department of Ganzhou Municipal Hospital.Based on the occlusion time,length and collateral circulation characteristics,intracranial artery occlusion was classified into 3 types(21 cases of typeⅠ,25 cases of typeⅡand 14 cases of typeⅢ).The vascular recanalization status[thrombolysis in cerebral infarction(TICI)evaluation system],national institute of health stroke scale(NIHSS)score and modified Rankin scale(mRS)score before and after surgery,and complications,stroke and surgery-related death within 30 days after surgery were evaluated among patients with different occlusion types.Result:There were statistically significant differences in the rates of combined hypertension,stroke history and preoperative disease condition diagnosis among three types(P<0.05),but gender,age,combined diabetes,hyperlipidemia,and coronary heart disease,the proportion of preoperative NIHSS score≤3 scores and mRS score≤2 scores revealed no statistically significant differences(P>0.05).The success rate of vascular recanalization in 60 patients was 95.00%,there was no statistical significance among patients with three types(P>0.05).At 30 days after surgery,the NIHSS scores and mRS scores Medical Innovation of China Vol.21,No.28 October,2024 of the three types were significantly reduced compared with those before surgery(P<0.05),and the NIHSS scores and mRS scores of patients with typeⅠand typeⅡwere significantly lower than those of patients with typeⅢ(P<0.05).Within 30 days after surgery,the total incidence rate of complications in 60 patients was 6.67%,without no significant di

关 键 词：颅内动脉 非急性闭塞 3D-DSA路图 血管再通术 不同分型 

分 类 号：R651.12[医药卫生—外科学]