优化救治流程与Solitaire FR支架在治疗急性脑动脉闭塞中的应用

发布时间：2018-03-01 04:13

本文关键词： 急性脑动脉闭塞血管内治疗机械取栓大血管闭塞疗效　出处：《山东大学学报(医学版)》2017年07期 　论文类型：期刊论文

【摘要】：目的探讨在优化救治流程中,应用支架取栓的方法治疗急性脑动脉闭塞(ACAO)的效果及安全性。方法回顾2013年1月至2016年12月进入优化救治流程中应用Solitaire FR支架取栓方法治疗的36例ACAO患者,血管再通标准采用m TICI分级,临床效果及预后采用美国国立卫生研究院卒中量表(NIHSS)评分,以及90 d改良Rankin评分(mRS)评价其疗效及安全性。结果 33例患者经血管内治疗后均成功开通闭塞血管(m TICI2b-3),2例患者经治疗后血管部分再通(m TICI 2a),1例患者仅有微量血流通过闭塞段(m TICI 1)。术前及术后NIHSS评分相比,差异有统计学意义(P0.05)。术后90 d改良Rankin评分(mRS)显示预后良好。其中0分5例,1分24例,2分4例,1例失访,2例死亡。33例患者随访期内复查无血管再闭塞,无症状性脑出血并发症。结论应用机械取栓治疗ACAO是安全、有效的,但应严格把握适应证及禁忌证。
[Abstract]:Objective to explore the optimal treatment process, The efficacy and safety of stent thrombectomy in the treatment of acute cerebral artery occlusion (ACAO) were retrospectively reviewed in 36 patients with ACAO who were treated with Solitaire FR stenting during the period from January 2013 to December 2016. The criteria for vascular recanalization were m TICI classification, and the clinical effect and prognosis were evaluated by the National Institutes of Health Stroke scale (NIH). The efficacy and safety were evaluated by modified Rankin score (90 d). Results after endovascular treatment, 33 patients were successfully treated with mTICI2b-3, 2 patients were treated with partial recanalization of blood vessel and 1 patient had only trace blood flow. The preoperative and postoperative NIHSS scores were compared between the occlusion segment and m TICI. The difference was statistically significant (P 0.05). The modified Rankin score (mRSs) showed a good prognosis 90 days after operation. Among them, 5 cases had 0 points, 24 cases had 1 score, 2 cases had lost visit and 1 case died. 33 cases had no re-occlusion during the follow-up period. Conclusion it is safe and effective to treat ACAO with mechanical thrombectomy, but the indications and contraindications should be strictly grasped.
【作者单位】：山东大学附属济南市中心医院神经外科;平阴县人民医院神经外科;齐河县人民医院神经内科;
【分类号】：R743.3

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