支架联合抽吸取栓术治疗颅内大血管急性闭塞的疗效分析

Curative Effect of Stent Combined with Thrombus Extraction for Acute Occlusion of Intracranial Large Vessels

目的 分析支架联合抽吸取栓术治疗颅内大血管急性闭塞的疗效。方法 选取2020年4月-2022年10月新疆医科大学第一附属医院收治的60例颅内大血管急性闭塞的老年患者为研究对象,以随机抽样法为分为对照组(n=30)及观察组(n=30)。对照组采取单一支架取栓术治疗,观察组采取支架联合抽吸取栓术治疗。对比两组动静脉再通时间、取栓次数、术中局部脑氧饱和度及治疗前后神经缺损程度量表(National Institute of Health Stroke Scale, NIHSS)、脑卒中预后量表(Modified Rankin Scale, MRS)波动情况、日常生活能力量表(Activity of Daily Living Scale, ADL)评分波动情况。结果 观察组动静脉再通时间(44.78±4.68)min、(86.31±8.77)min均长于对照组,取栓次数(1.84±0.19)次少于对照组,差异有统计学意义(t=5.957、3.601、14.060,P<0.05)。治疗后观察组NIHSS、MRS评分低于对照组,ADL评分高于对照组,差异有统计学意义(P<0.05)。结论 针对颅内大血管急性闭塞实施支架联合抽吸取栓术可取得较理想的疗效,预后良好且安全性有保障。

Objective To analyze the curative effect of stent combined with thrombus extraction for acute occlusion of intracranial large vessels.Methods Sixty elderly patients with acute intracranial large vessel occlusion admitted to the First Affiliated Hospital of Xinjiang Medical University from April 2020 to October 2022 were selected as the study objects,and were divided into control group(n=30)and observation group(n=30)by random sampling method.The control group was treated with single stent thrombectomy,and the observation group was treated with stent combined with thrombectomy.Compared the fluctuation of the National Institute of Health Stroke Scale(NIHSS),Modified Rankin Scale(MRS),and Activity of Daily Living Scale(ADL)scores before and after treatment,as well as the time of arterial and venous recanalization,the number of thrombus retrievals,intraoperative local cerebral oxygen saturation,and nerve defect severity before and after treatment between two groups.Results The observation group had longer ar⁃terial and venous recanalization times(44.78±4.68)min and(86.31±8.77)min compared to the control group,with fewer thrombus removal times(1.84±0.19)times compared to the control group,and the difference was statistically sig⁃nificant(t=5.957,3.601,14.060,P<0.05).After treatment,the NIHSS and MRS scores of the observation group were lower than those of the control group,while the ADL scores was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion For acute occlusion of intracranial large blood vessels,stent combined with thrombus extraction can achieve a better effect,a good prognosis and a guaranteed safety.