Solitaire支架机械取栓治疗急性缺血性卒中疗效分析

发布时间：2019-04-04 16:39

【摘要】：目的探讨Solitaire支架机械取栓术治疗急性缺血性卒中的疗效。方法回顾分析使用Solitaire支架取栓或静脉溶栓的急性缺血性卒中患者临床资料,分析患者治疗后再通情况,比较治疗前后NIHSS评分差异及随访3个月时mRS情况。结果 18例机械取栓患者均获得再通,17例完全再通,其中1例患者取栓术后局部狭窄行支架成形术;1例取栓后大脑前动脉A2段不显影。术后复查头颅CT平扫,1例为术区少量出血;1例患者出现大面积脑出血,出血后死亡;1例患者出现大面积脑梗死伴出血后死亡。患者术前NIHSS评分18.0(10.8,20.2)分,术后1周NIHSS评分9.0(5.0,14.2);3个月后随访mRS评分2分9例。16例静脉溶栓患者术前NIHSS评分16.0(10.0,20.0),术后1周NIHSS评分10.0(8.0,14.0),3个月后随访mRS评分2分5例。术前(Z=-0.434,P=0.664)和术后(Z=-0.313,P=0.754)的NIHSS评分在两组之间差异无统计学意义,但机械取栓组的NIHSS评分降低值大于静脉溶栓组(6.5 vs 6.0),差异有统计学意义(Z=-2.090,P=0.037);机械取栓组患者治疗后出院3个月mRS评分1.5(1.0,2.3)低于静脉溶栓组mRS评分4.5(1.0,4.8),并差异有统计学意义(Z=-2.015,P=0.044)。结论 Solitaire支架取栓治疗急性缺血性卒中再通率高,可以改善预后,是急性缺血性卒中的可选治疗方式。
[Abstract]:Objective to evaluate the efficacy of mechanical thrombectomy with Solitaire stents in the treatment of acute ischemic stroke. Methods the clinical data of patients with acute ischemic stroke treated with Solitaire stents or intravenous thrombolysis were retrospectively analyzed, and the recanalization after treatment was analyzed. The differences of NIHSS scores before and after treatment and the mRS status at 3 months follow-up were compared. Results all of the 18 patients were recanalized, and 17 patients were completely recanalized. One patient underwent stenting for local stenosis after thrombectomy, and one patient did not show A2 segment of anterior cerebral artery after thrombectomy. After operation, CT scan showed a small amount of hemorrhage in 1 case, massive cerebral hemorrhage in 1 case and death after hemorrhage in 1 case, large area cerebral infarction with hemorrhage in 1 case. The preoperative NIHSS score was 18.0 (10.8, 20.2), and the NIHSS score was 9.00 (5.0, 14.2) one week after operation. NIHSS score was 16.0 (10.0, 20.0) before operation in 16 patients, NIHSS score was 10.0 (8.0, 14.0) one week after operation, and mRS score was 2 points in 5 patients after 3 months of follow-up. MRS score was 2 (10.0, 20.0) in 16 patients with intravenous thrombolysis, 10.0 (8.0, 14.0) one week after operation. There was no significant difference in NIHSS scores between the two groups before operation (Z = 0.434, P = 0.664) and post-operation (Z = 0.313, P = 0.754), but the decrease of NIHSS score in the mechanical thrombectomy group was higher than that in the intravenous thrombolysis group (6.5vs 6.0). The difference was statistically significant (Z = 2.090, P = 0.037); The mRS scores of the patients in the mechanical thrombolysis group were lower than those in the intravenous thrombolytic group at 3 months after treatment (1.5 (1.0,2.3), 4.5 (1.0,4.8), respectively), and the difference was statistically significant (Z = 2.015, P < 0.044). Conclusion Thrombolization with Solitaire stents has a high recanalization rate and can improve the prognosis of acute ischemic stroke. It is an optional treatment for acute ischemic apoplexy.
【作者单位】：新疆医科大学第一附属医院;
【分类号】：R743.3

【相似文献】