上海交通大学学报(医学版) ›› 2018, Vol. 38 ›› Issue (9): 1128-.doi: 10.3969/j.issn.1674-8115.2018.09.021

• 综述 • 上一篇    下一篇

机械取栓在醒后卒中治疗中应用的研究进展

胡玥,何欣威,刘译升,赵蓉 ,刘建仁   

  1. 上海交通大学医学院附属第九人民医院神经内科,脑卒中中心,上海 200011
  • 出版日期:2018-09-28 发布日期:2018-10-15
  • 通讯作者: 赵蓉,电子信箱:zr1703@126.com。刘建仁,电子信箱:liujr021@sjtu.edu.cn。为共同通信作者。
  • 作者简介:胡玥(1994—),女,硕士生;电子信箱: 1111oxygen@sjtu.edu.cn。
  • 基金资助:
    上海市教育委员会高峰高原学科项目( 20161422);上海交通大学医学院临床研究项目( DLY201614);上海市科学技术委员会生物医药重点项目( 16411953100)

Application of mechanical thrombectomy in the patients with wake-up stroke

HU Yue, HE Xin-wei, LIU Yi-sheng, ZHAO Rong, LIU Jian-ren   

  1. Department of Neurology, Stroke Center, Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2018-09-28 Published:2018-10-15
  • Supported by:
    Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Support, 20161422; Clinical Research Project of Shanghai Jiao Tong University School of Medicine, DLY201614; Key Biological and Pharmaceutical Project of Shanghai Municipal Science and Technology Commission, 16411953100

摘要: 起病时间不明、短期治疗结局不佳的醒后卒中( wake-up stroke,WUS)约占所有卒中的 25%;且由于以上 2个特点,如何选择 WUS治疗方案仍在探索中。机械取栓是急性缺血性脑卒中( acute ischemic stroke,AIS)的一线治疗, DAWN和 DEFUSE-3研究证明其治疗时间窗可扩大至 24 h;且研究发现通过 CT灌注成像等影像学检查,选择具有“临床评分和影像学上梗死核心体积不匹配”的 WUS患者行血管内治疗仍安全而有效。该文就近年来机械取栓在 WUS治疗中的应用做一总结。

关键词: 醒后卒中, 急性缺血性脑卒中, 机械取栓, 脑灌注成像

Abstract:

Wake-up stroke (WUS), which is characterizedthe uncertain onset time and poor short-term outcome, accounts for 25% of stroke. Due to the above two points, how to choose the treatment methods remains to be researched. The mechanical thrombectomy is the first-line treatment of acute ischemic stroke (AIS). DAWN and DEFUSE-3 studies have recently demonstrated that the treatment window can be expanded to 24 hours, so the endovascular treatment may be effective and safe in some WUS patients according to the existence of “the mismatch of clinical score and imaging infart core”CT perfusion imaging and other modern imaging methods. This article summarized the application of mechanical thrombectomy in WUS treatment in recent years.

Key words: wake-up stroke, acute ischemic stroke, mechanical thrombectomy, cerebral perfusion imaging

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