本文選題：急性腦梗死　切入點：可回收支架　出處：《介入放射學雜志》2017年11期

【摘要】：目的探討支架植入作為補救性措施治療急性缺血性腦卒中的有效性與安全性。方法回顧性分析13例大腦前循環(huán)大血管閉塞發(fā)病8 h內(nèi)并接受補救性支架植入治療的急性缺血性腦卒中患者臨床資料。所有患者治療前均經(jīng)其它再通術(shù)式(靜脈溶栓、動脈溶栓、Penumbra裝置吸栓、Solitaire支架取栓)未果。根據(jù)腦梗死溶栓(TICI)治療后血流分級評價血管再通,記錄圍手術(shù)期出血及梗死并發(fā)癥。根據(jù)美國國立衛(wèi)生研究院卒中量表(NIHSS)評分評價術(shù)后1周神經(jīng)功能改善情況。根據(jù)改良Rankin量表(m RS)評分評價術(shù)后3個月預后指標。結(jié)果 13例接受補救性治療患者共植入支架16枚,支架植入前采用Solitaire可回收支架取栓10例,Penumbra裝置吸栓3例,經(jīng)靜脈尿激酶溶栓1例,經(jīng)動脈尿激酶溶栓1例。12例(92.3%)患者閉塞血管部分或全部再通(TICI≥2B/3)。NIHSS評分由術(shù)前平均(16.15±5.81)分改善為術(shù)后1周平均(8.08±5.61)分,差異有統(tǒng)計學意義(P0.05)。術(shù)后3個月,7例(53.8%)預后良好(m RS≤2),2例死亡。術(shù)后發(fā)生顱內(nèi)出血2例,手術(shù)相關(guān)栓塞3例。結(jié)論顱內(nèi)支架植入術(shù)作為不同組合藥物溶栓治療急性缺血性腦卒中患者血管再通的補救性措施,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.

【作者單位】： 鄭州大學人民醫(yī)院(河南省人民醫(yī)院)河南省介入治療中心;
【分類號】：R743.3

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本文編號：1710210