补救性支架植入治疗急性缺血性脑卒中13例

发布时间：2018-04-04 13:46

本文选题：急性脑梗死　切入点：可回收支架　出处：《介入放射学杂志》2017年11期

【摘要】：目的探讨支架植入作为补救性措施治疗急性缺血性脑卒中的有效性与安全性。方法回顾性分析13例大脑前循环大血管闭塞发病8 h内并接受补救性支架植入治疗的急性缺血性脑卒中患者临床资料。所有患者治疗前均经其它再通术式(静脉溶栓、动脉溶栓、Penumbra装置吸栓、Solitaire支架取栓)未果。根据脑梗死溶栓(TICI)治疗后血流分级评价血管再通,记录围手术期出血及梗死并发症。根据美国国立卫生研究院卒中量表(NIHSS)评分评价术后1周神经功能改善情况。根据改良Rankin量表(m RS)评分评价术后3个月预后指标。结果 13例接受补救性治疗患者共植入支架16枚,支架植入前采用Solitaire可回收支架取栓10例,Penumbra装置吸栓3例,经静脉尿激酶溶栓1例,经动脉尿激酶溶栓1例。12例(92.3%)患者闭塞血管部分或全部再通(TICI≥2B/3)。NIHSS评分由术前平均(16.15±5.81)分改善为术后1周平均(8.08±5.61)分,差异有统计学意义(P0.05)。术后3个月,7例(53.8%)预后良好(m RS≤2),2例死亡。术后发生颅内出血2例,手术相关栓塞3例。结论颅内支架植入术作为不同组合药物溶栓治疗急性缺血性脑卒中患者血管再通的补救性措施,安全有效。
[Abstract]:Objective to study the efficacy and safety of stent implantation as remedial measures in the treatment of acute ischemic stroke. Methods Retrospective analysis of 13 cases of anterior circulation cerebral vascular occlusion within 8 h of onset and accept remedial stent implantation in the treatment of acute ischemic stroke patients with clinical data. All patients were with other recanalization type (intravenous thrombolysis, intra-arterial thrombolysis, Penumbra absorber bolt, Solitaire stent thrombectomy) failed. According to the cerebral infarction (TICI) after the treatment of blood flow grading recanalization, records of perioperative hemorrhage and infarction complications. According to the National Institutes of Health Stroke Scale (NIHSS) was evaluated after 1 weeks of nerve function to improve the situation. According to the modified Rankin scale (m RS) 3 months after surgery. Prognostic index score evaluation results of the 13 cases accepted remedial treatment in patients with 16 stents were implanted stent implantation, before using Solitaire Recyclable Embolectomy in 10 cases, Penumbra 3 cases of aspiration device, 1 cases with intravenous urokinase thrombolysis, intra-arterial thrombolysis in 1 cases of.12 patients (92.3%) patients with occlusive vascular partial or complete recanalization (TICI = 2B/3).NIHSS score from preoperative average (16.15 + 5.81) improved 1 weeks after operation (average 8.08 + 5.61), the difference was statistically significant (P0.05). 3 months after surgery, 7 cases (53.8%) with good prognosis (m RS = 2), 2 cases died. 2 cases of postoperative intracranial hemorrhage, 3 cases of surgery related embolism. Conclusion intracranial stent implantation is safe and effective as different combinations of thrombolytic drugs the treatment of acute ischemic stroke patients with recanalization of remedial measures.

【作者单位】：郑州大学人民医院(河南省人民医院)河南省介入治疗中心;
【分类号】：R743.3

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