摘要
目的探讨急性前循环大血管闭塞支架取栓后预后不良的危险因素。方法选择2019年1月—2020年12月深圳市龙岗区人民医院收治的进行急性前循环大血管闭塞支架取栓后预后不良的患者62例为观察组,并选择同期取栓后预后良好的患者62例作为对照组,比较两组年龄、性别、闭塞部位、入院美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分、血管闭塞至再通时间等临床资料,对临床资料中的相关影响因素进行分析。结果单因素分析显示,急性前循环大血管闭塞支架取栓后预后不良与年龄、闭塞部位、侧支良好状况、入院NIHSS评分、术前Alberta卒中项目早期CT评分、手术时间、发病至再通时间、术后症状性脑出血、高血压等因素有关(P<0.05)。多因素分析显示,高龄、颈内动脉闭塞、侧支代偿不良、入院NIHSS评分增高、发病至再通时间延长及术后出现症状性脑出血为影响急性前循环大血管闭塞支架取栓后预后不良的危险因素(P<0.05)。结论对于急性前循环大血管闭塞型脑梗死支架取栓患者,术前积极筛查影响支架取栓不良预后的危险因素,术中采用积极措施,尽可能缩短血管再通时间,降低术后症状性脑出血发生率,从而有助于提高预后。
Objective To investigate the risk factors of poor prognosis after mechanical thrombectomyin acute anterior circulation occlusion.Methods A retrospective analysis of 62 cases of acute anterior circulation occlusion with poor prognosis after mechanical thrombectomy in our hospital from January 2019 to December 2020 was performed.In addition,62 patients with good prognosis after thrombectomy in the same period were selected as the control study.The clinical data such as age,gender,occlusion site,NIHSS score on admission,time from onset to recanalization were analyzed and compared between the two groups.The related factors in the clinical data were further analyzed by multivariate logistic regression analysis.Results Univariate analysis indicated that the poor prognosis of acute anterior circulation occlusion after mechanical thrombectomy was related to age,occlusion site,good collateral condition,NIHSS score at admission,preoperative aspects score,operation time,time from onset to recanalization,postoperative symptomatic cerebral hemorrhage,hypertension and other factors(P<0.05).The multivariate analysis showed that old age,internal carotid artery occlusion,poor collateral compensation,the higher NIHSS score,longer time from onset to recanalization and symptomatic cerebral hemorrhage were the risk factors for poor prognosis after mechanical thrombectomy in acute anterior circulation occlusion(P<0.05).Conclusion For patients with acute anterior circulation cerebral infarction with mechanical thrombectomy,preoperative screening of risk factors affecting the poor prognosis of stent mechanical thrombectomy,adopting intraoperative positive measures,as far as possible to shortening the recanalization time,and reducing the incidence of postoperative symptomatic cerebral hemorrhage,can help to improve the prognosis.
作者
廖一凡
贾军
董广宇
黄诚衙
LIAO Yifan;JIA Jun;DONG Guangyu;HUANG Chengya(Neurosurgery Department,Shenzhen Longgang District People's Hospital,Shenzhen 518000,Guangdong Province,China)
出处
《中国实用乡村医生杂志》
2022年第10期39-41,45,共4页
Chinese Practical Journal of Rural Doctor
关键词
前循环大血管闭塞
支架取栓
预后
危险因素
Anterior Circulation Occlusion
Stent Thrombectomy
Prognosis
Risk Factors
