摘要
目的探究Sofia远端导管直接抽吸与支架取栓用于急性脑梗死的临床疗效。方法回顾性分析2022年6月至2023年3月乐平市人民医院收治的60例急性脑梗死患者的临床资料,按照治疗方式的不同分为抽吸组(n=35)和支架组(n=25)。抽吸组采用Sofia远端导管直接抽吸治疗,支架组采用支架取栓治疗。比较两组围手术期指标、手术相关并发症发生率、术后血管再通改良脑梗死溶栓血流分级(modified thrombolysis in cerebral infarction scale,mTICI)、美国国立卫生研究所卒中量表(National Institutes of Health stroke scale,NIHSS)评分、血清炎症因子[超敏C反应蛋白(hypersensitive C reactive protein,hs-CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]水平以及改良Rankin量表(modified Rankin scale,mRS)评分和日常生活能力量表(activities of daily living scale,ADL)评分。结果抽吸组穿刺-血管成功再通时间短于支架组,取栓次数多于支架组,差异有统计学意义(P<0.05);两组住院时间比较差异无统计学意义。两组手术相关并发症发生率比较差异无统计学意义。抽吸组血管再通分级优于支架组,差异有统计学意义(P<0.05)。术后24 h、7 d,抽吸组NIHSS评分及hs-CRP、TNF-α水平均低于支架组,差异有统计学意义(P<0.05)。术后24 h,两组mRS、ADL评分比较差异无统计学意义;术后7、90 d,抽吸组mRS评分均低于支架组,ADL评分均高于支架组,差异有统计学意义(P<0.05)。结论与支架取栓相比,采用Sofia远端导管抽吸治疗急性脑梗死患者,血管再通时间更短,闭塞血管再通成功率更高,能有效改善患者神经功能、日常生活能力及炎症反应,利于预后,且安全性相当,值得临床推广应用。
Objective To explore the clinical efficacy of Sofia distal catheter direct aspiration and stent thrombectomy in acute cerebral infarction.Methods The clinical data of 60 patients with acute cerebral infarction admitted to Leping People's Hospital from June 2022 to March 2023 was retrospectively analyzed,they were divided into the aspiration group(n=35)and the stent group(n=25)according to different treatment methods.The aspiration group was treated with direct aspiration of the Sofia distal catheter,while the stent group was treated with stent thrombectomy.The perioperative indicators,the total incidence of surgery-related complications,the mTICI classification of postoperative vascular recanalization,and the National Institutes of Health stroke scale(NIHSS)scores,the levels of serum inflammatory factors(hypersensitive C reactive protein[hs-CRP],tumor necrosis factor-α[TNF-α]),as well as the modified Rankin scale(mRS)scores and the activities of daily living scale(ADL)scores were compared between the two groups.Results The successful recanalization time of the puncture-blood vessel in the aspiration group was shorter than that in the stent group,and the number of thrombectomy times was more than that in the stent group,and the differences were statistically significant(P<0.05);there was no statistically significant difference in the length of hospital stay between the two groups.There was no statistically significant difference in the incidence of surgery-related complications between the two groups.The grade of vasular recanalization in the aspiration group was better than that in the stent group,and the difference was statistically significant(P<0.05).At 24 h and 7 d after the operation,the NIHSS score,hs-CRP and TNF-αlevels in the aspiration group were lower than those in the stent group,and the differences were statistically significant(P<0.05).At 24 h after the operation,there were no statistically significant differences in the mRS And ADL scores between the two groups;at 7,90 d after the operation,the mRS score in the aspiration group was lower than that in the stent group,and the ADL score was higher than that in the stent group,and the differences were statistically significant(P<0.05).Conclusion Compared with stent thrombectomy,Sofia distal catheter aspiration for the treatment of patients with acute cerebral infarction has a shorter vascular recanalization time,a higher success rate of recanalization of occlusive vessels,can effectively improve the neurological function,daily living ability and inflammatory response of patients,as well as improve prognosis,and it is quite safe,it is worthy of clinical promotion and application.
作者
徐根华
靳晓军
王卫
XU Genhua;JIN Xiaojun;WANG Wei(Department of Neurology,Leping People's Hospital,Jingdezhen,Jiangxi,333300,China;Department of Neurology,Luannan County Hospital,Tangshan,Hebei,063500,China;Department of Neurosurgery,Leping People's Hospital,Jingdezhen,Jiangxi,333300,China)
出处
《当代医学》
2025年第5期8-13,共6页
Contemporary Medicine
关键词
Sofia远端导管直接抽吸
支架取栓
急性脑梗死
临床疗效
Sofia distal catheter
Direct aspiration
Stent thrombectomy
Acute cerebral infarction
Clinical efficacy
