颅内大血管闭塞血栓直接抽吸首次再通技术在急性脑梗死心源性和大动脉粥样硬化型大脑中动脉M1段闭塞血管内治疗中的临床效果

Clinical Effect of Direct Thrombus First Recanalization for Intracranial Large Vessel Occlusion in Patients with Intra-vascular Occlusion of M1 Segment of Middle Cerebral Artery of Acute Cerebral Infarction Cardiogenic and Great Atherosclerosis

目的:探讨颅内大血管闭塞血栓直接抽吸首次再通技术(ADAPT技术)在急性脑梗死心源性(CE)和大动脉粥样硬化(LAA)型大脑中动脉M1段闭塞血管内治疗中的临床效果。方法:选取2021年1月—2023年5月贵州医科大学第二附属医院收治的急性脑梗死CE和LAA型大脑中动脉M1段闭塞患者80例为观察对象,应用随机数字表法分为观察组(ADAPT技术治疗)与对照组(常规支架取栓治疗),各40例。比较两组90 d死亡率、术后出血情况、神经功能缺损程度分级量表(NIHSS)、改良Rankin量表(mRS)评分。结果:观察组90 d死亡率低于对照组,差异有统计学意义(P=0.048);观察组术后出血总发生率低于对照组,差异有统计学意义(P=0.019);治疗后,两组NIHSS、mRS评分均降低,观察组低于对照组,差异统计学有意义(P<0.05)。结论:在急性脑梗死CE和LAA型大脑中动脉M1段闭塞血管内治疗中,应用ADAPT技术,效果显著,可降低90 d死亡率,减少术后出血,改善患者神经功能。

Objective:To investigate the clinical effect of direct thrombus first recanalization technique(ADAPT technique)for in-tracranial large vessel occlusion in the treatment of intravascular occlusion of M1 segment of middle cerebral artery of acute cere-bral infarction cardiogenic(CE)and great atherosclerosis(LAA).Methods:A total of eighty patients with acute cerebral infarction CE and LAA type M1 middle cerebral artery occlusion admitted to the Second Affiliated Hospital of Guizhou Medical University from January 2021 to May 2023 were selected as the observation objects,and were divided into observation group(ADAPT tech-nology treatment)and control group(routine stent thrombus treatment)by random number table method,with forty cases in each group.The 90-day mortality,postoperative bleeding,neurological Impairment rating scale(NIHSS)and modified Rankin scale(mRS)scores were compared between the two groups.Results:The 90-day mortality rate of observation group was lower than that of control group,and the difference was statistically significant(P=0.048);The total incidence of postoperative bleeding in the ob-servation group was lower than that in the control group,and the difference was statistically significant(P=0.019);After treatment,NIHSS and mRS Scores in both groups were decreased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Conclusion:In the treatment of CE and LAA type M1 middle cerebral artery occlusion in acute cerebral infarction,ADAPT technology has a remarkable effect,which can reduce the 90-day mortality,reduce postopera-tive bleeding,and improve the neurological function of patients.