摘要
目的探讨急性脑血管闭塞机械再通术后出血性转化的影响因素,并探讨其防治策略。方法对本院收治的92例急性脑血管闭塞患者的临床资料进行回顾,均实施机械再通术。统计出血性转化的发生情况,对比出血性转化发生者和未发生者的预后;对比发生者和未发生者机械再通术后出血性转化的可能影响因素占比,分析危险因素。结果出血性转化发生率为28.26%,且发生者改良Rankin量表评分高于未发生者(P<0.05);发生者中高龄、合并原发性高血压、合并2型糖尿病、合并高脂血症、伴房颤、饮酒史、吸烟史、发病至入院时间>8 h、小动脉闭塞、梗死面积>3.0 cm2、入院美国国立卫生院卒中量表评分>14分、华法林抗凝占比均高于未发生者(P<0.05),经Logistic回归分析证实均为出血性转化的独立危险因素(P<0.05)。结论急性脑血管闭塞机械再通术后有出血性转化风险,且此类患者预后相对差,高龄、合并原发性高血压等均是其危险因素。
Objective To explore the influencing factors of hemorrhagic transformation after mechanical recanalization of acute cerebrovascular occlusion and its prevention and treatment strategies.Methods The clinical data of 92 patients with acute cerebral vascular occlusion in our hospital were reviewed.The occurrence of hemorrhagic transformation was statistically analyzed,and the prognosis of patients with and without hemorrhagic transformation was compared.The possible influencing factors of haemorrhagic transformation after mechanical recanalization were compared between the proportions of patients with and without mechanical recanalization,and the risk factors were analyzed.Results The incidence of hemorrhagic transformation was 28.26%,and the score of modified Rankin Scale score was higher in the patients with hemorrhagic transformation than that in the patients without hemorrhagic transformation(P<0.05).The proportions of elderly,hypertension,type 2 diabetes,hyperlipidemia,atrial fibrillation,drinking history,smoking history,time from onset to admission>8 h,arteriole occlusion,infarct area>3.0 cm^2,National Institutes of Health Stroke Scale score>14 scores,warfarin anticoagulation ratio were higher than those without(P<0.05),and Logistic regression analysis showed that they were independent risk factors of hemorrhagic transformation(P<0.05).Conclusion There is a risk of hemorrhagic transformation after mechanical recanalization of acute cerebrovascular occlusion,and the prognosis of such patients is relatively poor.The risk factors are old age,combined with essential hypertension and so on.
作者
曹光东
贺崇欣
夏连贵
Cao Guangdong;He Chongxin;Xia Liangui(Department of Neurosurgery Chizhou people's Hospital,Chizhou in Anhui,247000,China)
出处
《立体定向和功能性神经外科杂志》
2020年第5期293-299,共7页
Chinese Journal of Stereotactic and Functional Neurosurgery
关键词
急性脑血管闭塞
机械再通术
出血性转化
影响因素
Acute cerebral vascular occlusion
Mechanical recanalization
Hemorrhagic transformation
Influencing factors
作者简介
通讯作者:贺崇欣,hytsd1231@163.com
