急性脑梗死机械取栓后颅内出血转化的影响因素分析

Analysis of influencing factors of intracranial hemorrhage transformation after mechanical thrombectomy in acute cerebral infarction

目的:探讨急性脑梗死患者机械取栓后出现颅内出血转化的危险因素并提出相关预防建议.方法:以深圳市人民医院连续纳入的45例急性脑梗死机械取栓治疗的患者为研究对象,收集患者的基线资料,根据术后复查头颅CT或MRI结果将患者分为颅内出血(HT)组和无HT组,分析两组患者基线资料情况,使用Logistic回归模型分析颅内HT的危险因素.结果:45例纳入患者颅内HT转化14例(31.11%),HT组患者房颤比例、ORT、术前NIHSS评分、取栓部位为前循环比例、术后收缩压水平均明显高于非HT组,有统计学差异,P值均<0.05,分别为0.026、0.012、0.041、0.020、0.038;Logistic回归分析发现房颤、ORT、术前NIHSS评分是影响急性脑梗死患者取栓术后颅内HT的独立危险因素.结论:有房颤病史、ORT时间延长、术前较高的NIHSS评分会增加急性脑梗死患者机械取栓术后发生颅内HT的风险.

Objective:To investigate the risk factors of intracranial hemorrhage transformation after mechanical thrombectomy in patients with acute cerebral infarction and to put forward some preventive suggestions.Methods:In shenzhen people's hospital,45 cases of acute cerebral infarction after mechanical thrombectomy were recruited continously as participants.After collected the baseline data,according to the results of the review of head CT or MRI,patients were divided into HT and non HT groups to analyze the data of two groups of patients with baseline results,using Logistic regression was conducted to analyze the risk factors of intracranial HT.Results:The proportion of atrial fibrillation,ORT time,preoperative NIHSS scores,precirculation ratio of thrombectomy site,and postoperative systolic blood pressure in the HT group were significantly higher than those in the non-ht group,with statistical significant differences(P<0.05),P value were 0.026,0.012,0.041,0.020,0.038 respectively.Logistic regression analysis found that atrial fibrillation,ORT and preoperative NIHSS scores were independent risk factors for intracranial HT after thrombectomy in patients of acute cerebral infarction.Conclusion:Atrial fibrillation,prolonged ORT and higher preoperative NIHSS scores increase the risk of intracranial HT after mechanical thrombectomy in patients of acute cerebral infarction.