手术时间对机械取栓病人术后症状性颅内出血及预后的影响

Effect of procedure time on symptomatic intracranial hemorrhage and prognosis in patients treated by mechanical thrombectomy

目的探讨急性缺血性脑卒中病人进行机械取栓治疗时,手术时间对术后症状性颅内出血(symptomatic intracranial hemorrhage,sICH)及预后的影响。方法回顾性分析145例行机械取栓治疗的急性缺血性脑卒中病人的临床资料。分别比较sICH组与无sICH组之间、预后良好组和预后不良组之间病人的临床特征及手术参数,并将组间比较结果中P<0.10的指标纳入多因素Logistic回归模型进行分析。结果多因素Logistic回归分析结果表明:手术时间延长及入院时高血糖、高NIHSS评分是术后发生sICH的独立危险因素(P<0.05);而手术时间延长、高龄、入院时高NIHSS评分是病人预后不良的独立危险因素(P<0.05)。结论手术时间延长可导致急性缺血性脑卒中病人出现sICH及预后不良,术者有必要尽量缩短手术时间,以减少并发症的发生,争取获得更好的预后。

Objective To investigate the effect of procedure time on postoperative symptomatic intracranial hemorrhage(sICH)and prognosis in patients with acute ischemic stroke treated by mechanical thrombectomy.Methods Clinical data of 145 patients with acute ischemic stroke treated by mechanical thrombectomy were analyzed retrospectively.The clinical characteristics and surgical parameters of patients were compared between the sICH group and non-sICH group and between the good prognosis group and poor prognosis group.The index of P<0.10 in the comparison between the groups was incorporated into the multivariate logistic regression model for analysis.Results Multivariate logistic regression analysis showed that prolonged operation time,high serum glucose and high NIHSS score on admission were the independent risk factors for postoperative sICH(P<0.05),while prolonged operative time,elder age and high NIHSS score on admission were independent risk factors for postoperative sICH(P<0.05).Conclusions Prolonged procedure time can lead to sICH and poor prognosis in patients with acute ischemic stroke,and it is necessary for the surgeon to shorten the procedure time as much as possible,in order to reduce the incidence of complications and get better prognosis.