ISTMT治疗急性脑中动脉闭塞的临床效果评估  

Clinical efficacy evalution of ISTMT in treating acute middle cerebral artery occlusion

作　　者：蒋旭[1] 林凯倩 JIANG Xu;LIN Kaiqian(Department of Electrical Science,Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China;Guilin Metallurgical Sanatorium of Guangxi Zhuang Autonomous Region,Guilin 541006,China)

机构地区：[1]广西壮族自治区南溪山医院电生理科,桂林541002 [2]广西壮族自治区桂林冶金疗养院,桂林541006

出　　处：《华夏医学》2025年第2期171-178,共8页Acta Medicinae Sinica

基　　金：广西壮族自治区卫生健康委员会项目(Z20201500)。

摘　　要：目的评估颅内史赛克Trevo XP取栓支架机械取栓术(ISTMT)治疗急性大脑中动脉闭塞(AMCAO)的临床疗效。方法选取60例AMCAO患者随机分为对照组(单纯支架取栓术,30例)和观察组(ISTMT,30例)。比较两组血管再通率、预后、并发症、神经功能、定量脑电图(QEEG)和血清神经损伤标志物水平等。结果观察组血管再通率(93.33%),高于对照组(70.00%),90 d预后良好率(90.00%)优于对照组(63.33%),并发症发生率(13.33%)低于对照组(36.67%),美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(MRS)评分低于对照组(P<0.05)。QEEG的δ/α相对功率比等参数与对照组差异显著(P<0.05),且观察组神经生长因子(NGF)高于对照组,神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)、中枢神经特异性蛋白(S-100β)水平低于对照组(P<0.05)。结论ISTMT治疗能有效改善AMCAO患者神经功能,显示出良好的临床疗效和安全性。QEEG参数可预测患者预后,血清神经损伤标志物的变化佐证了手术效果。Objective To evaluate the clinical efficacy of Intracranial Stryker Trevo XP Stent Retriever Mechanical Thrombectomy(ISTMT)in treating Acute Middle Cerebral Artery Occlusion(AMCAO).Methods 60 patients with AMCAO were randomly divided into the control group(30 cases were underwent stent thrombectomy alone)and an observation group(30 cases were underwent ISTMT).The study compared vascular recanalization rates,90 d prognosis,complication rates,neurological function damage and recovery,Quantitative Electroencephalography(QEEG)parameters,and serum levels of neuroinjury markers,etc.Results The reperfusion rate of the observation group was 93.33%higher than 70.00%of the control group,the good prognosis rate at 90 days was 90.00%better than 63.33%of the control group,the incidence of complications was 13.33%lower than 36.67%of the control group,and the National Institutes of Health Stroke Scale(NIHSS)and Modified Rankin Scale(MRS)scores were lower than those of the control group(P<0.05).Theδ/αrelative power ratio and other parameters of QEEG were significantly different from those of the control group(P<0.05),and the observation group had higher levels of nerve growth factor(NGF)than the control group,while the levels of neuron specific enolase(NSE),glial fibrillary acidic protein(GFAP),and central nervous system specific protein(S-100β)were lower than those of the control group(P<0.05).Conclusion ISTMT treatment can effectively improve the neurological function of AMCAO patients,demonstrating good clinical efficacy and safety.QEEG parameters can predict patient prognosis,and changes in serum nerve injury markers confirm surgical outcomes.

关 键 词：颅内史赛克Trevo XP取栓支架机械取栓术 急性大脑中动脉闭塞 临床疗效 定量脑电图 神经功能恢复 

分 类 号：R743[医药卫生—神经病学与精神病学]