超时间窗急性前循环脑梗死患者血管内治疗的临床分析

Endovascular treatment in patients with acute anterior circulation cerebral infarction beyond time window:A clinical analysis

目的:探讨超时间窗急性前循环脑梗死患者血管内治疗的临床特点及疗效。方法:回顾性分析2017年1月至2019年1月云浮市人民医院收治的超时间窗急性前循环脑梗死患者的临床资料,所有患者均接受血管内治疗。所有患者进行TOAST分型和美国国立卫生研究院卒中量表(NIHSS)评分,术前基于CT平扫(NC-CT)进行阿尔伯特卒中项目早期CT评分(ASPECTS)。出院后随访,行改良Rankin评分(mRS)。结果:共10例患者纳入本研究,其中男7例、女3例,TOAST分型均为大动脉粥样硬化型,术前NIHSS评分均大于7分、ASPECTS评分大于5分。术后随访显示,7例ASPECTS评分大于7分的患者出院后3个月mRS评分为0~1分;3例ASPECTS评分为5~6分的患者出院后3个月mRS评分为4~5分。结论:基于NC-CT的ASPECTS评分大于7分的超时间窗急性前循环脑梗死患者进行血管内治疗可能获益。

Objective:To investigate the clinical characteristics and efficacy of endovascular treatment in patients with acute anterior circulation cerebral infarction beyond time window.Methods:The clinical data of patients with acute anterior circulation cerebral infarction beyond time window admitted to Yunfu Municipal People’s Hospital between January 2017 and January 2019 were retrospectively analyzed.All patients received endovascular treatment.All patients were evaluated by TOAST classification and National Institutes of Health Stroke Scale(NIHSS)score.The Alberta Stroke Program Early CT Score(ASPECTS)was used based on CT plain scan(NC-CT)at the baseline.All patients were followed up discharged home,and the modified Rankin score(mRS)was used.Results:Ten patients were included in the study,including 7 males and 3 females.The TOAST classification was all aortic atherosclerosis.The preoperative NIHSS score was greater than 7 points,and the ASPECTS score was greater than 5 points.The postoperative follow-up showed that the mRS score was 0 to 3 points in 7 patients with ASPECTS score greater than 7 points,and was 5 to 6 points in 3 patients with ASPECTS score of 5 to 6 points at 3 months after discharged home.Conclusion:Endovascular treatment may be beneficial for patients with acute anterior circulation cerebral infarction beyond time window with ASPECTS score greater than 7 points based on NC-CT.