Solitaire AB支架在治疗急性缺血性脑卒中的临床疗效分析

发布时间：2018-05-03 10:03

本文选题：急性缺血性脑卒中 + Solitaire　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:分析Solitaire AB支架在治疗急性缺血性脑卒中的治疗效果及评估其有效性及安全性并分析影响临床预后的相关风险因素。方法:本文回顾性分析我院及我校附属解放军二六四医院2014年11月-2016年6月期间使用solitaire AB支架取栓治疗急性缺血性脑卒中患者61例,入选病例均符合急性缺血性脑卒中闭塞诊断标准,术前都行头颅CT排除颅内出血及行CTA或MRA证实大动脉血管闭塞。通过分析61例患者经过solitaire AB支架治疗后血管再通情况、术后并发症、临床预后及分析影响预后相关风险因素。结果:61例确诊为AIS患者,入院后给予患者行solitaire AB取栓,男性患者36例(59%),女性患者25例(42%);年龄30~86岁,平均(69.7±12.3)岁;从入院时的美国卫生研究院卒中量表NIHSS(National Institutes of Health Stroke Scale)(22.5±5.8)提高至出院时NIHSS评分(4.33±3.73),(P㩳0.01);54例患者血管再通[89%(TICI"g2b)],其中19例为TICI为2b级,35例为3级;4例患者死亡,死亡率达6.6%;3月随访良好预后率为45%(MRS"f2);经单因素卡方检验及logistic回归分析得出糖尿病、房颤、术前GCS评分、术前NIHSS评分是影响预后独立风险因素。结论:1.Solitaire AB支架在AIS中有较高的血管再通率,有效改善患者预后。2.机械取栓时间窗并不是固定的,可根据患者情况适当放宽,患者术后效果也较满意。3.糖尿病、房颤、吸烟、嗜酒、术前GCS、术前NIHSS评分是患者预后独立风险因素。
[Abstract]:Objective: to analyze the therapeutic effect of Solitaire AB stent in the treatment of acute ischemic stroke, evaluate its effectiveness and safety, and analyze the related risk factors affecting the clinical prognosis. Methods: a retrospective analysis of the use of solitaire AB stent in our hospital and the 264 affiliated Liberation Army Hospital of China in June -2016 November 2014 61 patients with acute ischemic stroke were treated with acute ischemic stroke occlusion. Before operation, intracranial hemorrhage was excluded and CTA or MRA confirmed large artery occlusion. After the analysis of 61 patients after Solitaire AB stent treatment, postoperative vascular recanalization, postoperative complications, clinical prognosis and analysis were analyzed. Outcome related risk factors. Results: 61 cases were diagnosed as AIS patients and were given Solitaire AB thrombectomy after admission, 36 male patients (59%), 25 female patients (42%); age 30~86 years, average (69.7 + 12.3) years of age; from the admission to the hospital of American Institutes of health apoplexy (National Institutes of Health Stroke Scale) (22.5 + 5.8) (22.5 + 5.8) The NIHSS score was (4.33 + 3.73), (P? 0.01), 54 patients were re passed [89% (TICI "G2B)], 19 were TICI 2B, 35 were 3, 4 patients died, the death rate was 6.6%, and the good prognosis rate was 45% (MRS" F2) in March; the single factor chi square test and logistic regression analysis showed that diabetes, atrial fibrillation, preoperative GCS score, NIHSS review before operation Conclusion: 1.Solitaire AB stent has high vascular repassage rate in AIS. The time window of.2. mechanical thrombectomy is not fixed effectively to improve the prognosis of patients. It can be relaxed according to the patient's condition. The postoperative effect of the patient is also satisfied with.3. diabetes, atrial fibrillation, smoking, alcohol, GCS, and preoperative NIHSS score. An independent risk factor for the prognosis.

【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

【参考文献】