急性前循环脑梗死介入术后即刻头颅CT高密度征影响因素分析

Analysis of the influencing factors of high density CT signs immediately after transcatheter closure of acute anterior circulation cerebral artery occlusion

目的分析急性前循环脑梗死介入术后即刻头颅CT高密度征影响因素。方法取2014年9月至2020年5月间扬州大学附属医院神经介入中心就诊的150例因急性前循环闭塞行急诊动脉溶栓取栓患者术后即刻头颅CT影像资料,从中选取图像质量良好、24 h内有MRI或CT复查的病例,根据术后即刻头颅CT有无脑实质高密度征,将研究病例分为两组:观察组即脑实质高密度征组(n=102)和对照组即无脑实质高密度征组(n=48)。获取研究对象的性别、年龄、生活习惯、血管危险因素、术前ASPECTS评分、入院NIHSS评分、OTT时间及介入治疗方法等资料,分析研究术后即刻头颅CT高密度征的相关影响因素。结果两组患者在性别、年龄、生活习惯、血管危险因素、OTT时间、介入治疗方法等组间差异无统计学意义(P>0.05);两组病例入院NIHSS评分、术前ASPECTS评分与介入术后脑实质高密度征组间差异有统计学意义(P<0.05)。结论术前低ASPECTS评分与高NIHSS评分是急性前循环动脉闭塞开通术后即刻头颅CT高密度征的信号表征,提示谨慎选择介入手术方式。

Objective To analyze the influencing factors of high-density CT signs of acute anterior circulation,cerebral artery occlusion immediately after intervention.Methods From September 2014 to May 2020,150 patients with acute anterior circulation occlusion who underwent emergency arterial thrombolysis were selected from the Neurointerventional center of Affiliated Hospital of Yangzhou University.The patients with good image quality and MRI or CT reexamination within 24 hours were selected the patients were divided into two groups according to whether there was brain parenchymal high-density sign on CT immediately after operation:observation group(n=102)and control group(n=48).The data of gender,age,living habits,vascular risk factors,preoperative ASPECTS score,admission NIHSS score,OTT time and interventional treatment methods were obtained,and the related influencing factors of immediate postoperative head CT high density syndrome were analyzed.Results there was no significant difference between the two groups in gender,age,living habits,vascular risk factors,OTT time and interventional treatment methods(P>0.05);there was an significant difference between the two groups in admission NIHSS score,preoperative ASPECTS score and cerebral parenchymal high density syndrome(P<0.05).Conclusion preoperative low ASPECTS score and high admission NIHSS score are the signal features of high-density CT signs immediately after acute anterior circulation artery occlusion,suggesting careful selection of interventional operation.