期刊文献+

球囊扩张或血管支架在急性大脑中动脉M1段机械取栓治疗失败患者中的有效性和安全性对比研究 预览

Comparatively research the efficacy and safety of balloon dilation and vascular stent in patients with mechanical thrombe-ctomy treatment failure in acute middle cerebral artery M1 segment occlusion
在线阅读 下载PDF
分享 导出
摘要 目的探讨球囊扩张或血管支架补救治疗对急性大脑中动脉M1段机械取栓治疗失败患者的安全性和有效性,并分析患者预后的影响因素。方法回顾性分析2014年1月至2018年6月中国人民解放军陆军军医大学第二附属医院综合卒中中心和其他19家综合卒中中心80例急性大脑中动脉M1段机械取栓治疗失败并行补救治疗达到闭塞血管血流改良脑梗死溶栓分级(modi?ed thrombolysis in cerebral infarction score,m TICI)≥2b级患者的临床资料,根据补救治疗方法将其分为球囊扩张组(30例)和血管支架植入组(50例)。比较两组患者90 d改良Rankin量表(modi?ed Rankin scale,m RS)评分、血管再闭塞率、症状性颅内出血发生率及死亡率,并对影响患者预后的相关因素进行多因素Logistic回归分析。结果球囊扩张组中90 d mRS评分0~2分患者占比明显高于血管支架植入组(P <0.05);两组患者血管再闭塞率、死亡率及症状性颅内出血发生率比较均无显著差异(P_均> 0.05)。多因素Logistic回归分析显示:卒中病史(OR=8.968,95%CI:1.162~69.196,P=0.035)、补救治疗方式(OR=0.243,95%CI:0.066~0.894,P=0.033)、侧支循环(OR=3.873,95%CI:1.029~14.576,P=0.045)及基线美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分(OR=0.809,95%CI:0.701~0.934,P=0.004)均为急性大脑中动脉M1段闭塞取栓失败后行补救治疗患者神经功能预后的独立危险因素(P_均<0.05)。结论机械取栓联合球囊扩张能够有效改善急性大脑中动脉M1段闭塞性缺血性脑卒中患者神经功能,并未增加手术风险,且补救治疗方式是影响患者治疗后神经功能的独立危险因素。 Objective To research the safety and ef?cacy of balloon dilatation and vascular stent rescue treatment in patients with mechanical thrombectomy treatment failure in acute middle cerebral artery M1 segment occlusion, and analyze the factors affecting prognosis. Method Retrospectively analyze the clinical data of 80 patients achieved the goal of modi?ed thrombolysis in cerebral infarction score(mTICI) ≥ 2 b by rescue treatment after mechanical thrombectomy failure in acute middle cerebral artery M1 segment occlusion from January 2014 to June 2018 in comprehensive stroke center of the Second Af?liated Hospital of Army Medical University of the Chinese People’s Liberation Army and other 19 comprehensive stroke centers. According to the rescue treatment,they were divided into balloon dilatation group(30 cases) and vascular stent implantation group(50 cases). The 90-day modified Rankin scale(mRS) score, reocclusion rate, symptomatic intracranial hemorrhage, and mortality were compared between the two groups. Logistic multivariate analysis was performed on related factors affecting prognosis. Result The percentage of patients with90-day mRS score 0 2 points in balloon dilatation group was signi?cantly higher than that in vascular stent implantation group(P < 0.05). There were no signi?cant differences in the incidence of vascular re-occlusion, mortality and symptomatic intracranial hemorrhage between the two groups(Pall> 0.05). Multivariate Logistic correlation analysis showed that stroke history(OR = 8.968,95%CI: 1.162~ 69.196, P = 0.035), rescue treatment(OR = 0.243, 95%CI: 0.066~0.894, P = 0.033), collateral circulation(OR = 3.873, 95%CI: 1.029~14.576, P = 0.045) and baseline National Institute of Health stroke scale(NIHSS) score(OR =0.809, 95%CI: 0.701~0.934, P = 0.004) were independent risk factors for neurological prognosis in patients. Conclusion Mechanical thrombectomy combined with balloon dilatation can effectively improve the neurological prognosis of patients with acute middle cerebral artery M1 segment
作者 岳成松 资文杰 邱忠明 李凤利 杨峻 刘瀚圣 刘文华 黄文国 时忠华 杨世泉 邱涛 张帅 曾国勇 周宏斌 王琰 艾志斌 刘勇 胡伟 万跃 温昌明 田喜光 周志明 王振 李冰 陈忠伦 吴德平 陈路明 余鹏霄 罗伟东 刘帅 龚自力 YUE Cheng-song;ZI Wen-jie;QIU Zhong-ming;LI Feng-li;YANG Jun;LIU Han-sheng;LIU Wen-hua;HUANG Wen-guo;SHI Zhong-hua;YANG Shi-quan;QIU Tao;ZHANG Shuai;ZENG Guo-yong;ZHOU Hong-bin;WANG Yan;AI Zhi-bin;LIU Yong;HU Wei;WAN Yue;WEN Chang-ming;TIAN Xi-guang;ZHOU Zhi-ming;WANG Zhen;LI Bing;CHEN Zhong-lun;WU De-ping;CHEN Lu-ming;YU Peng-xiao;LUO Wei-dong;LIU Shuai;GONG Zi-li(Department of Neurology,the Second Affiliated Hospital of Army Medical University of the Chinese People's Liberation Army,Chongqing 400037,China;Department of Neurology,Wuhan First Hospital,Wuhan 430022,China;Department of Neurology,Maoming Traditional Chinese Medicine Hospital,Guangdong,Maoming 525000,China;Department of Neurology,NO.904 Hospital of Chinese People's Liberation,Jiangsu,Wuxi 214008,China;Department of Neurology,NO.902 Hospital of Chinese People's Liberation,Anhui,Bengbu 233010,China;Department of Neurology,Zigong First People's Hospital,Sichuan,Zigong 643000,China;Department of Neurology,Yangzhou First People's Hospital,Jiangsu,Yangzhou 225001,China;Department of Neurology,Ganzhou People's Hospital,Jiangxi,Ganzhou 341001,China;Department of Neurology,Xiangyang Central Hospital,Hubei,Xiangyang 441021,China;Department of Neurology,Chengdu Fifth People's Hospital,Chengdu 611130,China;Department of Neurology,Taihe Hospital,Hubei,Shiyan 442008,China;Department of Neurology,Lu'an Hospital,Anhui,Lu'an 237016,China;Department of Neurology,Anhui Provincial Hospital,Hefei 230001,China;Department of Neurology,Hubei Third People's Hospital,Wuhan 430032,China;Department of Neurology,Nanyang Central Hospital,Henan,Nanyang 473003,China;Department of Neurology,Guangdong Armed Police Corps Hospital,Guangzhou 510507,China;Department of Neurology,Yijishan Hospital of Wannan Medical College,Anhui,Wuhu 241001,China;Department of Neurology,Changsha Central Hospital,Changsha 410004,China;Department of Neurology,Yan Tai Major Yuhuangding Hospital,Shandong,Yantai 264099,China;Department of Neurology,Mianyang Central Hospital,Sichuan,Mianyang 621000,China)
出处 《中国医学前沿杂志(电子版)》 2019年第2期73-79,共7页 Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词 急性缺血性脑卒中 大脑中动脉M1段闭塞 机械取栓 球囊扩张 血管支架植入 Acute ischemic stroke M1 segment occlusion of middle cerebral artery Mechanical thrombectomy Balloon dilatation Vascular stent implantation
作者简介 通讯作者:龚自力E-mail:gzl_944@163.com
  • 相关文献
投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈