Li Liang, Cheng Peipei, Zhang Jiwei, Wang Guang, Hu Tiemin, Sun Fan
Liang Li, Department of Neurosurgery, The Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, P.R. China.
Peipei Cheng Department of Pediatrics, The Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, P.R. China.
Pak J Med Sci. 2022 May-Jun;38(5):1107-1112. doi: 10.12669/pjms.38.5.5723.
To explore the clinical effect and prognostic factors of mechanical thrombectomy in the treatment of acute ischemic stroke.
The records of patients with acute ischemic stroke treated in our hospital from April 2020 to April 2021 were retrospectively selected. A total of 65 patients were treated with mechanical thrombectomy. After treatment, they were scored with modified Rankin Scale (MRS). The treatment effect and prognostic factors were analyzed.
The occluded vessels were successfully opened in 65 patients. The recanalization rate was 96.92%. There were no serious complications of thrombectomy. The time from femoral artery puncture to vascular recanalization was (84.06±16.64) minutes and the number of thrombectomies was (2.52±0.71). There were 42 patients with good prognosis and 23 patients with poor prognosis. Analysis of the prognostic factors showed that the time from onset to admission in the good prognosis group was shorter, the NIHSS score before thrombectomy was higher, and the Alberta stroke program early CT Score (ASPECT) score was lower as compared to the patients in the poor prognosis group. The grade of vascular recanalization in the good prognosis group was better than that in the poor prognosis group, and the level of PCT was lower (P<0.05). Logistic regression analysis showed that the time from onset to admission, NIHSS and ASPECT scores before thrombectomy were the prognostic factors of mechanical thrombectomy in the treatment of acute ischemic stroke.
Mechanical thrombectomy is effective in the treatment of acute ischemic stroke and can effectively promote the recanalization of occluded vessels, but the NIHSS and ASPECT scores from the onset to the time of admission before thrombectomy can directly affect the prognosis of patients.
探讨机械取栓术治疗急性缺血性脑卒中的临床疗效及预后因素。
回顾性选取2020年4月至2021年4月在我院接受治疗的急性缺血性脑卒中患者的病历。共有65例患者接受了机械取栓术。治疗后,采用改良Rankin量表(MRS)进行评分。分析治疗效果及预后因素。
65例患者闭塞血管成功开通,再通率为96.92%。取栓术无严重并发症。股动脉穿刺至血管再通时间为(84.06±16.64)分钟,取栓次数为(2.52±0.71)次。预后良好42例,预后不良23例。预后因素分析显示,与预后不良组患者相比,预后良好组患者从发病到入院的时间较短,取栓术前NIHSS评分较高,阿尔伯塔卒中项目早期CT评分(ASPECT)较低。预后良好组血管再通分级优于预后不良组,PCT水平较低(P<0.05)。Logistic回归分析显示,从发病到入院的时间、取栓术前NIHSS评分和ASPECT评分是机械取栓术治疗急性缺血性脑卒中的预后因素。
机械取栓术治疗急性缺血性脑卒中有效,可有效促进闭塞血管再通,但取栓术前从发病到入院的NIHSS评分和ASPECT评分可直接影响患者预后。