SWIM取栓和单支架取栓技术在急性前循环大血管闭塞患者中的效果对比  

Comparison of Application of SWIM Thrombectomy and Single Stent Thrombectomy in Patients with Acute Anterior Circulation Large Vessel Occlusion

作　　者：董明安 管民[2] 赵礼荣 王琪 DONG Ming’an;GUAN Min;ZHAO Lirong;WANG Qi(The Second Department of Neurology,Pingdingshan Second People’s Hospital,Pingdingshan 467100,China;Department of Cerebrovascular Diseases,Henan People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]平顶山市第二人民医院神经内二科,河南平顶山467100 [2]河南省人民医院脑血管病科,河南郑州450003

出　　处：《河南医学研究》2025年第5期841-844,共4页Henan Medical Research

摘　　要：目的对比支撑管道辅助Solitaire FR支架机械取栓术(SWIM)与单支架取栓术在急性前循环大血管闭塞患者中的应用效果。方法回顾性分析平顶山市第二人民医院2020年1月至2023年3月收治的82例急性前循环大血管闭塞患者的临床资料,按照手术方法分为单支架组(单支架取栓术治疗,40例)和SWIM组(SWIM治疗,42例),比较两组手术围手术期相关指数、术后血管再通情况,两组术前和术后2周神经功能、生活功能情况,术后3个月随访症状性出血转化率、颅脑出血率情况。结果SWIM组手术开通时间、取栓次数、住院时间、住院总费用均小于单支架组(P<0.05);两组血管再通情况(0级、1级、2a级、2b级、3级)差异无统计学意义(P>0.05);术后2周,两组美国国立卫生研究院卒中量表(NIHSS)评分均降低(P<0.05),且SWIM组与单支架组差异有统计学意义(P<0.05),术后2周,两组日常生活能力评估表(ADL)评分均升高(P<0.05),且SWIM组与单支架组差异有统计学意义(P<0.05);随访3个月,两组症状性出血转化率、颅脑出血率差异均无统计学意义(P>0.05)。结论SWIM与单支架取栓术治疗急性前循环大血管闭塞均可获得不错的血管再通率,但相比于单支架取栓术,SWIM治疗急性前循环大血管闭塞患者术后神经功能和生活质量更佳。Objective To compare the application effects of support catheter-assisted Solitaire FR stent mechanical thrombectomy(SWIM)and single stent thrombectomy on patients with acute anterior circulation large vessel occlusion.Methods The clinical data of 82 patients with acute anterior circulation large vessel occlusion in Pingdingshan Second People’s Hospital between January 2020 and March 2023 were retrospectively analyzed.According to surgical methods,the patients were divided into single stent group(single stent thrombectomy,40 cases)and SWIM group(SWIM treatment,40 cases).Perioperative related indicators and postoperative vascular recanalization,neurological function and life function status before surgery and at 2 weeks after surgery,symptomatic hemorrhage conversion rate and craniocerebral hemorrhage rate at 3 months of follow-up after surgery were compared between the two groups.Results The surgery starting time,frequency of thrombectomy,hospital stay and total cost of hospitalization in SWIM group were less than those in single stent group(P<0.05).There was no statistically significant difference in the vascular recanalization status between the two groups(grade 0,grade 1,grade 2a,grade 2b,grade 3)(P>0.05).At 2 weeks after surgery,the National Institute of Health stroke scale(NIHSS)scores of the two groups were reduced(P<0.05),and the score of SWIM group was significantly different from that of single stent group(P<0.05).At 2 weeks after surgery,the activity of daily living(ADL)scores of the two groups were increased(P<0.05),and the difference in the score was significant between SWIM group and single stent group(P<0.05).During 3-month follow-up,there were no statistical differences in the symptomatic hemorrhage conversion rate and craniocerebral hemorrhage rate between the two groups(P>0.05).Conclusion Both SWIM and single stent thrombectomy in the treatment of acute anterior circulation large vessel occlusion can obtain a good vascular recanalization rate,but compared with single stent thrombectomy,SWIM has

关 键 词：急性前循环大血管闭塞 支撑管道辅助Solitaire FR支架机械取栓术 单支架取栓术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]