【摘要】：目的探討應用Solitaire AB支架機械取栓治療靜脈溶栓禁忌的急性缺血性腦卒中的療效和安全性。方法回顧性分析2015年1月~2016年8月在吉林大學第二醫(yī)院接受Solitaire AB支架機械取栓治療的19例靜脈溶栓禁忌的急性缺血性腦卒中患者的臨床資料。男性13例,女性6例,年齡30~82歲,靜脈溶栓禁忌的因素為超過最佳溶栓時間窗(6 h)和(或)NIHSS評分較高(22)。采用t檢驗比較患者術前和術后腦梗死溶栓分級(TICI分級)、術前和術后1 w的NIHSS評分的變化評價療效,采用術后90 d改良的Rankin量表(mRS)評估預后。結果 19例患者中的18例責任血管均成功獲得再通,再通率94.7%。從發(fā)病到血管再通時間:頸內動脈系統(tǒng)為(6.8±1.5)h,椎動脈系統(tǒng)為(10.0±2.9)h,其中從穿刺到再通時間為(83.3±39.9)min。術前NIHSS評分為(27.3±9.0)分,術后7 d時NIHSS評分為(9.71±7.98)分,較術前有明顯改善(P0.01)。術后90 d隨訪,預后良好者11例(mRS 0~2),預后良好率為57.89%,死亡3例,死亡率為15.79%。結論 Solitaire AB支架取栓治療靜脈溶栓禁忌的急性缺血性腦卒中安全有效,血管再通率高,可明顯改善臨床預后。
[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 鹵1.5) h in the internal carotid artery system and (10.0 鹵2.9) h in the vertebral artery system, in which the time from puncture to recanalization was (83.3 鹵39.9) min.. The preoperative NIHSS score was (27.3 鹵9.0) and the NIHSS score was (9.71 鹵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.
【作者單位】： 吉林大學第二醫(yī)院神經內科;吉林大學第二醫(yī)院神經外科;
【分類號】：R651.12

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