抽吸联合支架取栓对超时间窗后循环缺血性脑卒中患者脑血灌注的影响OACSTPCD
Effects of aspiration combine stent for thrombectomy on cerebral blood perfusion in patients with posterior circulation ischemic stroke beyond the time window
目的 探究抽吸联合支架取栓对超时间窗后循环缺血性脑卒中患者脑血灌注的影响.方法 选择徐州医科大学附属常熟医院(常熟市第二人民医院)神经内科自2018年6月至2022年6月收治97例超时间窗后循环缺血性脑卒中患者作为研究对象.根据治疗方案将患者分为2组,药物溶栓组(48例)予重组组织型纤溶酶原激活剂药物溶栓治疗,取栓组(49例)予抽吸联合支架取栓治疗.比较2组患者治疗前后脑血灌注情况,血清神经元特异性烯醇化酶(NSE)、内皮型一氧化氮合酶(eNOS)水平,不良反应及预后情况.结果 2组患者治疗后脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)及脑血流量(CBF)等脑血灌注情况较治疗前显著改善,取栓组患者治疗后CBV、CBF显著高于药物溶栓组,MTT、TTP明显短于药物溶栓组,差异均有统计学意义(P＜0.05).2组患者治疗后血清NSE水平低于治疗前,eNOS水平高于治疗前,且取栓组血清NSE水平低于药物溶栓组,eNOS水平高于药物溶栓组,差异均有统计学意义(P＜0.05).取栓组患者的不良反应发生率(16.33％)低于药物溶栓组(35.42％),预后良好率(89.90％)高于药物溶栓组(72.92％),差异均有统计学意义(P＜0.05).结论 抽吸联合支架取栓有助于改善超时间窗后循环缺血性脑卒中患者脑血灌注,治疗疗效及安全性优异.
Objective To investigate the effects of aspiration combine stent for thrombolectomy on cerebral blood perfusion in patients with posterior circulation ischemic stroke beyond the time window.Methods A total of 97 patients with posterior circulation ischemic stroke beyond the time window who were admitted to Neurology Department of Changshu Hospital Affiliated to Xuzhou Medical University from June 2018 to June 2022 were selected as the study subjects.They were divided into drug thrombolysis group(n=48,thrombolysis with recombinant tissue plasminogen activator)and thrombectomy group(n=49,aspiration combine stent for thrombectomy)based on treatment plan.Cerebral blood perfusion,serum neuron-specific enolase(NSE)and endothelial nitric oxide synthase(eNOS)levels,adverse reactions,and prognosis were compared between two groups before and after treatment.Results After treatment,the cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP)and cerebral blood flow(CBF)of two groups significantly improved compared to before treatment,the CBV and CBF of the thrombectomy group were significantly higher than those of the drug thrombolysis group,while the MTT and TTP were significantly shorter than those of the drug thrombolysis group,and the differences were statistically significant(P＜0.05).After treatment,the serum NSE level was lower than before treatment,and the eNOS level was higher than before treatment in two groups of patients,the serum NSE level in the thrombectomy group was lower than that in the drug thrombolysis group,and the eNOS level was higher than that in the drug thrombolysis group,with statistical significance(P＜0.05).The incidence of adverse reactions in the thrombectomy group(16.33％)was lower than that in the drug thrombolysis group(35.42％),and the good prognosis rate(89.90％)was higher than that in the drug thrombolysis group(72.92％),with statistical significance(P＜0.05).Conclusion Aspiration combine stent for thrombectomy is beneficial to improve cerebral blood perfusion in patients with posterior circulation ischemic stroke beyond the time window,with significant curative effect and good safety.
李旺俊;王云霞
215500 苏州,徐州医科大学附属常熟医院(常熟市第二人民医院)神经内科215500 苏州,徐州医科大学附属常熟医院(常熟市第二人民医院)神经内科
抽吸联合支架取栓超时间窗后循环缺血性脑卒中脑血灌注
Aspiration combine stent for thrombectomyBeyond the time windowPosterior circulation ischemic strokeCerebral blood perfusion
《中华脑科疾病与康复杂志（电子版）》 2023 (6)
352-357,6
Xuzhou Medical University Affiliated Hospital Development Fund Project(XYFM2021050)徐州医科大学附属医院发展基金项目(XYFM2021050)
评论