上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (7): 764-.doi: 10.3969/j.issn.1674-8115.2019.07.013

• 论著·临床研究 • 上一篇    下一篇

多次取栓对急性缺血性脑卒中患者预后的影响

何泓 1, 2，刘译升 1，赵蓉 1，李格飞 1，史妍慧 1，李轶 3，刘建仁 1   

  1. 1.上海交通大学医学院附属第九人民医院神经内科，上海 200011；2. 上海交通大学医学院附属第九人民医院黄浦分院神经内科，上海 200011； 3. 上海交通大学医学院附属新华医院神经外科，上海 200092
  • 出版日期:2019-07-28 发布日期:2019-08-26
  • 通讯作者: 刘建仁，电子信箱：liujr021@vip.163.com；李轶，电子信箱：liyi@xinhuamed.com.cn。为共同通信作者。
  • 作者简介:何泓（1977—），女，主治医师，硕士生；电子信箱： 18939925515@189.cn。
  • 基金资助:
    上海市科学技术委员会科普项目（18dz2313603）；上海市科学技术委员会生物医药支撑项目（16411953100）；上海交通大学医学院多中心临床研究项目（DLY201614）

Impact of multiple thrombectomy on outcomes of patients with acute ischemic stroke

HE Hong1, 2, LIU Yi-sheng1, ZHAO Rong1, LI Ge-fei1, SHI Yan-hui1, LI Yi3, LIU Jian-ren1   

  1. 1. Department of Neurology, Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; 2. Department of Neurology, Shanghai Ninth Peoples Hospital Huangpu Branch, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China; 3. Department of Neurosurgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
  • Online:2019-07-28 Published:2019-08-26
  • Supported by:
    Science Popularization Project of Shanghai Municipal Science and Technology Commission, 18dz2313603; Biomedicine Key Program Shanghai Municipal Science and Technology Commission,16411953100; Clinical Research Project Shanghai Jiao Tong University School of Medicine, DLY201614

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摘要： 目的 ·研究急性缺血性脑卒中患者进行机械性取栓治疗 (mechanical thrombectomy，MT)时，取栓次数对预后的影响。方法 ·对上海交通大学医学院附属第九人民医院 2013年 3月— 2018年 4月收治的 88例急性脑卒中行 MT的患者临床资料进行回顾性分析。根据取栓次数，将患者分为取栓次数较少组（A组，取栓次数≤ 2次）和多次取栓组（B组，取栓次数 > 2次）。比较 2组患者血管开通率、脑出血发生率、术后 7 d美国国立卫生研究院脑卒中量表 ( National Institute of Health Stroke Scale，NIHSS)评分和死亡率、术后 90 d改良 Rankin评分（modified Rankin score，mRs）和死亡率等预后情况。结果 · A组与 B组相比，脑出血发生率、7 d症状改善率和 90 d良好预后率的差异无统计学意义（均 P>0.05），但 A组 7 d死亡率和 90 d死亡率均低于 B组（P0.003，P0.031）， A组血管开通率明显高于 B组（P0.010）。结论 ·多次取栓对于急性缺血性脑卒中患者术后脑出血、早期症状改善和 90 d良好预后无明显影响，但与血管开通率和死亡率有关。

关键词: 急性缺血性脑卒中, 机械性取栓治疗, 取栓次数, 脑血管再通

Abstract:

Objective · To study the effect of the number of thrombectomy on the prognosis of patients with acute ischemic stroke treated with mechanical thrombectomy (MT). Methods · Retrospective analysis was performed in 88 acute ischemic stroke patients treated with MT in Shanghai Ninth Peoples Hospital March 2013 to April 2018. Based on the number of thrombectomy, all the patients were divided into the group with lower number of thrombectomy (group A) ( ≤ 2 times of thrombectomy) and the group with higher number of thrombectomy (group B) (>2 times of thrombectomy). Revascularization rate, incidence of intracerebral hemorrhage, score of National Institute of Health Stroke Scale (NIHSS) and mortality at 7 d after surgery, modified Rankin score (mRs) and mortality at 90 d after surgery were compared between the two groups. Results · Compared with group B, there were no statistically significant differences in the incidence of intracerebral hemorrhage, and rates of symptom improvement at 7 d and good prognosis at 90 d in group A (all P>0.05). But the mortality at 7 d and 90 d in group A was lower than that in group B (P0.003, P0.031), and the rate of successful revascularization in group A was significantly higher than that in group B (P0.010). Conclusion · Multiple thrombectomy is not significantly correlated with intracerebral hemorrhage, early symptom improvement and good prognosis at 90 d, but it is correlated with the rates of revascularization and mortality.

Key words: acute ischemic stroke, mechanical thrombectomy, number of thrombectomy, cerebral revascularization

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