ADAPT与SWIM取栓技术对急性缺血性脑卒中患者治疗效果的比较分析  

A comparative analysis of therapeutic effect of a direct aspiration first-pass thrombectomy(ADAPT)and solitaire FR with intracranial support catheter for mechanical thrombectomy(SWIM)in patients with acute ischemic stroke

作　　者：臧哈尔·哈布德勒 苑扬 顿晓熠 王晓蓓 阿布都沙拉穆·孜亚吾丁 赵嘉乐 吴勤奋 Zanghaer Habudele;YUAN Yang;DUN Xiaoyi;WANG Xiaobei;Abdushalamu Ziyawuding;ZHAO Jiale;WU Qinfen(The Second Affiliated Hospital of Xinjiang Medical University,Xinjiang Key Laboratory of Neurological Disorder Research,Urumqi 830063,China;The Fifth Affiliated Hospital of Xinjiang Medical University,Key Laboratory of High Incidence Disease Research in Xinjiang,Urumqi 830000,China;Xinjiang Medical University,Urumqi 830017,China)

机构地区：[1]新疆医科大学第二附属医院,新疆神经系统疾病研究重点实验室,乌鲁木齐830063 [2]新疆医科大学第五附属医院,新疆地区高发疾病研究教育部重点实验室,乌鲁木齐830000 [3]新疆医科大学,乌鲁木齐830017

出　　处：《新疆医科大学学报》2025年第3期268-272,276,共6页Journal of Xinjiang Medical University

基　　金：“天山英才”医药卫生高层次人才培养计划项目(TSYC202301A024)。

摘　　要：目的探讨在急性缺血性脑卒中患者中应用直接抽吸一次性取栓(A direct aspiration First-Pass thrombectomy,ADAPT)进行血管再通的安全性、可行性及技术优势。方法回顾性分析本院神经内科2021年3月至2023年10月接受血管再通术治疗的54例急性脑卒中患者。根据取栓技术的不同,患者被分为研究组(应用ADAPT技术直接抽吸取栓,34例)和对照组[应用Solitaire FR支架机械取栓术(Solitaire FR with intracranial support catheter for mechanical thrombectomy,SWIM),20例]。比较两组的取栓次数、手术操作时间、血管完全再通率、术前与术后2周美国国立卫生研究院卒中量表(National institutes of health stroke scale,NIHSS)评分、并发症发生率及术后3个月良好预后率。结果两组采用不同取栓技术后,研究组的取栓次数和手术操作时间均低于对照组(P<0.05)。术前两组的NIHSS评分差异无统计学意义(P>0.05)。术后2周,研究组的NIHSS评分显著低于对照组(P<0.05)。两组的血管完全再通率分别为70.59%和75.00%,术后3个月良好预后率分别为64.71%和60.00%,两组间差异无统计学意义(P>0.05)。研究组的并发症发生率(8.82%)显著低于对照组(20.00%)(P<0.05)。结论与SWIM取栓技术相比,ADAPT技术在血管再通率上无显著差异,但能显著减少急性脑卒中患者的取栓次数和手术操作时间,提升术后3个月的良好预后率,改善术后2周的NIHSS评分,并降低并发症发生率。ADAPT技术在改善患者功能恢复和降低并发症方面显示了更大的潜力,为急性缺血性脑卒中的临床治疗提供了有力的替代方案。Objective To investigate the safety,feasibility and technical advantages of using a direct aspiration first-pass thrombectomy(ADAPT)for vascular recanalization in patients with acute ischemic stroke.Methods A retrospective analysis was conducted on 54 patients with acute stroke who received vascular recanalization treatment in the hospital between March 2021 and October 2023.According to the thrombectomy techniques used,the patients were divided into the study group(34 patients who received ADAPT technique for direct aspiration thrombectomy)and the control group[20 patients who received standard stent retriever thrombectomy combined with intermediate catheter aspiration(SWIM)].Comparisons were made between the 2 groups regarding the number of thrombectomy attempts,operation time,complete vascular recanalization rate,national institutes of health stroke scale(NIHSS)scores before and 2 weeks after the surgery,complication rates and good outcome rates at 3 months postoperatively.Results Using different thrombectomy techniques,the study group required fewer attempts and had a shorter surgical duration compared to the control group(P<0.05).Before the surgery,NIHSS scores were statistically similar between the 2 groups(P>0.05).2 weeks post-surgery,NIHSS scores in the study group were significantly lower compared to the control group(P<0.05).Complete revascularization rates were 70.59%in the study group and 75.00%in the control group;good prognosis rates at 3 months were 64.71%and 60.00%,respectively.Differences were not statistically significant(P>0.05).Complication rates were significantly lower in the study group(8.82%)compared to the control group(20.00%)(P<0.05).Conclusion Compared with SWIM thrombectomy technique,ADAPT technology showed no significant difference in the vascular recanalization rate,but it significantly reduced the number of thrombectomy attempts and operation time in patients with acute stroke,improved the good outcome rate at 3 months postoperatively,enhanced NIHSS scores 2 weeks postoperatively,a

关 键 词：急性脑卒中 ADAPT技术 取栓 并发症 血管再通 

分 类 号：R743.3[医药卫生—神经病学与精神病学]