Solitaire AB支架取栓治疗静脉溶栓禁忌的急性缺血性脑卒中

发布时间：2018-12-15 00:45

【摘要】：目的探讨应用Solitaire AB支架机械取栓治疗静脉溶栓禁忌的急性缺血性脑卒中的疗效和安全性。方法回顾性分析2015年1月~2016年8月在吉林大学第二医院接受Solitaire AB支架机械取栓治疗的19例静脉溶栓禁忌的急性缺血性脑卒中患者的临床资料。男性13例,女性6例,年龄30~82岁,静脉溶栓禁忌的因素为超过最佳溶栓时间窗(6 h)和(或)NIHSS评分较高(22)。采用t检验比较患者术前和术后脑梗死溶栓分级(TICI分级)、术前和术后1 w的NIHSS评分的变化评价疗效,采用术后90 d改良的Rankin量表(mRS)评估预后。结果 19例患者中的18例责任血管均成功获得再通,再通率94.7%。从发病到血管再通时间:颈内动脉系统为(6.8±1.5)h,椎动脉系统为(10.0±2.9)h,其中从穿刺到再通时间为(83.3±39.9)min。术前NIHSS评分为(27.3±9.0)分,术后7 d时NIHSS评分为(9.71±7.98)分,较术前有明显改善(P0.01)。术后90 d随访,预后良好者11例(mRS 0~2),预后良好率为57.89%,死亡3例,死亡率为15.79%。结论 Solitaire AB支架取栓治疗静脉溶栓禁忌的急性缺血性脑卒中安全有效,血管再通率高,可明显改善临床预后。
[Abstract]:Objective to investigate the efficacy and safety of mechanical thrombolysis with Solitaire AB stent in the treatment of acute ischemic stroke with contraindication of venous thrombolysis. Methods the clinical data of 19 patients with acute ischemic stroke who received mechanical thrombolysis with Solitaire AB stent from January 2015 to August 2016 in Jilin University second Hospital were retrospectively analyzed. There were 13 males and 6 females aged 30 to 82 years. The contraindication factors of venous thrombolysis were higher than the optimal thrombolytic time window (6 h) and / or NIHSS score (22). T test was used to compare the preoperative and postoperative cerebral infarction thrombolytic grading (TICI), the changes of NIHSS score before and 1 week after operation, and the prognosis was evaluated by modified Rankin (mRS) 90 days after operation. Results all the responsible vessels were successfully re-opened in 18 of the 19 patients, and the recanalization rate was 94.7%. The time from onset to recanalization was (6.8 卤1.5) h in the internal carotid artery system and (10.0 卤2.9) h in the vertebral artery system, in which the time from puncture to recanalization was (83.3 卤39.9) min.. The preoperative NIHSS score was (27.3 卤9.0) and the NIHSS score was (9.71 卤7.98) on the 7th day after operation, which was significantly improved than that before operation (P0.01). After 90 days follow-up, 11 cases had good prognosis (mRS 0 / 2), the good prognosis rate was 57.89%, 3 cases died, the mortality rate was 15.79 9%. Conclusion the treatment of venous thrombolytic contraindication acute ischemic stroke with Solitaire AB stent is safe and effective, and the vascular recanalization rate is high, which can obviously improve the clinical prognosis.
【作者单位】：吉林大学第二医院神经内科;吉林大学第二医院神经外科;
【分类号】：R651.12

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