本文選題：基底動脈閉塞 + 腦梗死��； 參考：《南方醫(yī)科大學(xué)》2017年碩士論文

【摘要】：第一章急性基底動脈閉塞所致腦梗死的起病特征與病變部位的相關(guān)性目的:急性基底動脈閉塞所致腦梗死臨床癥狀、體征復(fù)雜,表現(xiàn)形式多樣。本文旨在探討急性基底動脈閉塞所致腦梗死的起病特征與病變部位的相關(guān)性。方法:收集53例急性基底動脈閉塞所致后循環(huán)梗死患者的臨床資料,根據(jù)起病形式將患者分為急進(jìn)型組及緩慢進(jìn)展組,結(jié)合腦血管造影結(jié)果進(jìn)行回顧性分析。結(jié)果:急進(jìn)型組血管閉塞部位多位于基底動脈中段及上段,緩慢進(jìn)展組則多為基底動脈下段,兩組之間有顯著統(tǒng)計學(xué)差異(P0.05)。Logistic回歸分析結(jié)果顯示,與基底動脈上段閉塞的患者相比,下段閉塞患者的起病方式更傾向于緩慢進(jìn)展型(OR=14.77,95%CI:1.57-139.00,P=0.019)。結(jié)論:急性基底動脈閉塞所致腦梗死的起病特征與病變部位具有相關(guān)性,早期診斷、及時治療有助于改善患者的臨床預(yù)后。第二章急性基底動脈閉塞血管內(nèi)治療臨床預(yù)后影響因素分析目的:急性基底動脈閉塞所致缺血性卒中具有高致死率、高致殘率特點。本文旨在探討基底動脈閉塞血管內(nèi)治療臨床預(yù)后及影響因素。方法:本研究連續(xù)納入2007年1月至2016年7月在南京軍區(qū)南京總醫(yī)院經(jīng)全腦數(shù)字減影血管造影術(shù)(Digital subtraction angiography,DSA)確診急性基底動脈閉塞并行血管內(nèi)介入治療的53例患者。術(shù)后3月隨訪時按生活自理程度,根據(jù)改良的Rankin評分(mRS)將患者分為兩組;(1)良好預(yù)后組(mRS4分),(2)不良好預(yù)后組(mRS≥4分)。結(jié)果:應(yīng)用多因素Logistic回歸模型分析探討影響基底動脈閉塞患者血管內(nèi)治療臨床預(yù)后的因素。以P0.05為差異有顯著統(tǒng)計學(xué)意義。Logistic回歸分析結(jié)果顯示,在校正了 NIHSS評分、ASITN_SIR評分、血管再通因素后,入院時低 NIHSS 評分(OR= 0.114,95%CI:0.019-0.689,P=0.018)、高 ASITN_SIR評分(OR = 0.035,95%CI:0.005-0.239,P=0.001)及有效血管再通(OR=0.113,95%CI:0.017-0.767,P=0.026)的患者預(yù)后良好(三者均P0.005);而高 NIHSS評分、低ASITN_SIR評分及血管再通不佳提示患者不良預(yù)后。結(jié)論:采用血管內(nèi)介入治療急性基底動脈閉塞的患者中,入院時低NIHSS評分、高ASTTN_SIR評分及有效血管再通者預(yù)后良好。
[Abstract]:Chapter 1 the correlation between the onset characteristics of cerebral infarction caused by acute basilar artery occlusion and the location of cerebral infarction objective: the clinical symptoms and signs of acute basilar artery occlusion are complicated and the manifestations are varied. The purpose of this study was to investigate the correlation between the onset and location of cerebral infarction caused by acute basilar artery occlusion. Methods: the clinical data of 53 patients with posterior circulation infarction caused by acute basilar artery occlusion were collected. Results: the location of vessel occlusion in the acute type group was mostly located in the middle and upper part of the basilar artery, while in the slow progress group, it was mostly in the lower part of the basilar artery. There was a significant difference between the two groups (P 0.05). The logistic regression analysis showed that there was a significant difference between the two groups. Compared with the patients with upper basilar artery occlusion, the patients with lower segment occlusion were more prone to the slow progression type ORA 14.77-95 CI: 1.57-139.00 P0. 019. Conclusion: the onset features of cerebral infarction caused by acute basilar artery occlusion are related to the location of the lesion. Early diagnosis and timely treatment are helpful to improve the clinical prognosis of patients with acute basilar artery occlusion. Chapter 2 Analysis of prognostic factors in patients with acute basilar artery occlusion objective: ischemic stroke caused by acute basilar artery occlusion is characterized by high mortality and high disability rate. The purpose of this study was to investigate the clinical prognosis and influencing factors of endovascular treatment of basilar artery occlusion. Methods: from January 2007 to July 2016, 53 patients with acute basilar artery occlusion diagnosed by digital subtraction angiography and endovascular therapy in Nanjing General Hospital of Nanjing military region were included in this study. At 3 months follow-up, patients were divided into two groups according to the degree of self-care, according to the modified Rankin score. The patients were divided into two groups. Results: multivariate Logistic regression model was used to analyze the prognostic factors in patients with basilar artery occlusion. Logistic regression analysis showed that after adjusting the NIHSS score with ASITNSIR score and vascular recanalization factor, On admission, the patients with low NIHSS score (OR = 0.11495 CI: 0.019-0.689), high ASITN_SIR score (OR = 0.035 鹵95CI: 0.005-0.239P0.001) and effective vascular recanalization (OR0.11395 CIW 0.017-0.767P0.026) had a good prognosis (all P 0.005), while high NIHSS score, low ASITN_SIR score and poor vascular recanalization suggested a poor prognosis. Conclusion: the patients with acute basilar artery occlusion treated by endovascular intervention have a good prognosis with low NIHSS score, high ASTTN_SIR score and effective vascular recanalization.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R743.3

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本文編號：1832251