摘要
目的 探讨不同时间窗支架取栓系统对前循环急性脑梗死(ACI)患者的治疗效果。方法 选取2018年3月至2021年3月在我院接受治疗的前循环ACI患者102例,根据患者症状至股动脉穿刺时间分为时间窗内组64例(≤6 h)以及超时间窗组38例(>6 h),比较两组手术治疗相关参数、神经功能、扩散加权成像(DWI)梗死体积及预后。结果 时间窗内组患者症状至影像检查、症状至动脉穿刺、动脉穿刺至再通时间均短于超时间窗组(P<0.05),两组患者治疗后血管完全通畅率、取栓次数、桥接/直接取栓比值、症状性颅内出血发生率以及治疗3个月的改良RANKIN量表(mRS)评分差异无统计学意义(P>0.05);治疗后24 h时间窗内组患者梗死体积增长小于超时间窗组(P<0.05);治疗2周后时间窗内组患者神经功能缺损评分(NIHSS)低于超时间窗组(P<0.05),Alberta卒中项目早期CT评分(ASPECT)高于超时间窗组(P<0.05)。结论 时间窗内以及超时间窗进行支架取栓系统治疗,均可有效改善前循环ACI的临床症状,时间窗内患者短期内神经功能改善效果更佳,而中远期效果相当。
Objective To explore the therapeutic effects of stent thrombectomy with different time windows in the systemic treatment of anterior circulation acute cerebral infarction.Methods A total of 102 patients with anterior circulation acute cerebral infarction treated in our hospital between March 2018 and March 2021 were selected. According to the time from symptom to femoral artery puncture, the patients were divided into a within time window group(≤ 6 hours and n=64) and a beyond time window group(> 6 hours and n=38). The surgical treatment related parameters, neurological function, diffusion weighted imaging(DWI) infarct volume and prognosis were compared between the two groups.Results The time from symptom to imaging examination, symptom to artery puncture, and artery puncture to recanalization in the within time window group were shorter than those in the beyond time window group(P<0.05). After treatment, there was no significance in the complete patency rate of blood vessels, thrombectomy times, bridging to direct embolectomy ratio, and incidence of symptomatic intracranial hemorrhage between the two groups and the modified Rankin scale(mRS) scores after 3 months of treatment(P>0.05). After treatment, the growth of infarct volume in the within the 24 h time window group was smaller than that in the beyond the time window group(P<0.05). After 2 weeks of treatment, the neurological impairment score of the within time window group was lower than that of the beyond time window group(P<0.05), while the Alberta stroke program early CT(ASPECT) score of the within time window group was higher than that of the beyond time window group(P<0.05).Conclusions Both stent thrombectomy within and beyond the time window can effectively improve the clinical symptoms of anterior circulation acute cerebral infarction. The former can better improve the patients′ neurological function in the short term, while the effects in the medium term and long term are equivalent between the two groups.
作者
钟川
田永攀
吴继祥
覃国勇
ZHONG Chuan;TIAN Yong-pan;WU Ji-xiang;QIN Guo-yong(Chongqing Dazu District People's Hospital,Chongqing 402360,China)
出处
《实用医院临床杂志》
2023年第1期89-92,共4页
Practical Journal of Clinical Medicine
基金
重庆市卫计委医学科研项目(编号:2017MSXM136)。
关键词
前循环急性脑梗死
支架取栓系统治疗
时间窗
血管完全通畅率
改良RANKIN量表
Anterior circulation acute cerebral infarction
Stent thrombectomy
Time windows
Complete patency rate of blood vessel
Modified Rankin scale
