ADAPT技术与支架取栓术对高龄急性缺血性脑卒中患者的疗效分析

Analysis of Curative Effect of ADAPT Technique and Ctent Thrombus Removal in Elderly Patients with Acute Cerebral Ischemic Stroke

目的评价直接一次性抽吸取栓(ADAPT)技术与支架取栓术对于高龄急性缺血性脑卒中患者的疗效和安全性。方法选择2018年1月至2019年11月在我院进行取栓的急性颅内血管闭塞患者70例,按照手术方式分为ADAPT组和支架组,比较两组一般资料、术前美国国立卫生研究所卒中量表(NIHSS)评分、手术信息及临床预后,采用二元Logistic回归分析判定手术方式是否为影响临床预后的因素。结果两组患者在性别、年龄、既往史和术前NIHSS评分上,差异均无统计学意义(P>0.05);两组患者股动脉穿刺至再通时间、血管再通率、术后NIHSS评分、90dmRS、症状性出血率以及是否静脉溶栓等指标比较,差异均无统计学意义(P>0.05);采用二元Logistic回归分析,以不同临床结局为因变量,结果显示,性别、手术方式、血管再通率、年龄并不是影响临床结局的因素(P>0.05),术前NIHSS评分(P=0.031)和股动脉穿刺至再通时间(P=0.010)是临床预后良好的独立预测因子。结论在高龄急性缺血性脑卒中患者中,ADAPT技术与常规支架取栓术具有相同的疗效和安全性。

Objective To evaluate efficacy and safety of a direct aspiration first pass technique(ADAPT)and stent embolectomy for elderly patients with acute ischemic stroke.Methods From January 2018 to November 2019,70 patients with acute intracranial vascular occlusion who under went thrombectomy in our hospital were selected.They were divided into ADAPT group and stent group according to surgical method.General information,preoperative national institutes of health stroke scale(NIHSS),surgical information and clinical prognosis were compared.Binary logistic regression analysis was used to determine whether surgical method was a factor affecting clinical prognosis.Results There were no statistically significant differences in gender,age,past history and preoperative NIHSS score(P>0.05).There were no statistically significant differences in time from femoral artery puncture to recanalization,vascular recanalization rate,postoperative NIHSS score,90dmRS,symptomatic bleeding rate,and intravenous thrombolysis(P>0.05).Binary logistic regression analysis was used.dependent variableswas different clinical outcomes,and results showed that gender,surgical methods,vascular recanalization rate and age were not factors that affect clinical outcomes(P>0.05).Preoperative NIHSS score(P=0.031)and time from femoral artery puncture to recanalization(P=0.010)were independent predictors of good clinical prognosis.Conclusion In elderly patients with acute ischemic stroke,ADAPT technology has the same efficacy and safety as conventional stent thrombectomy.