抽吸取栓术与支架取栓术治疗大脑中动脉M1段急性闭塞的效果比较OA
Comparison of the effect of aspiration thrombectomy and stent thrombec-tomy in the treatment of acute occlusion of the M1 segment of the middle cerebral artery
目的 分析抽吸取栓术与支架取栓术用于治疗大脑中动脉 M1 段急性闭塞的效果.方法 回顾性分析 2020 年1 月至 2025 年 11 月齐齐哈尔医学院附属第一医院卒中中心进行急诊介入治疗的 60 例早期急性大血管闭塞脑梗死患者的临床资料,根据手术方式不同分为抽吸取栓组(28 例)和支架取栓组(32 例).比较两组手术相关指标(首次取栓再通率、穿刺至手术结束时间等)、并发症(医源性夹层、血管痉挛等)及临床预后评分.结果 抽吸取栓组首次取栓再通率及首次取栓装置成功再通率低于支架取栓组,血管痉挛发生率高于支架取栓组,穿刺至手术结束时间短于支架取栓组,差异有统计学意义(P＜0.05).抽吸取栓组最终血管成功再通率、症状性颅内出血发生率及术后 90 d 改良 Rankin 量表评分与支架取栓组比较,差异无统计学意义(P＞0.05).支架取栓组并发症总发生率低于抽吸取栓组,差异有统计学意义(P＜0.05).结论 支架取栓术在急性大脑中动脉 M1 段闭塞治疗中首次取栓再通效率更高,但抽吸取栓术操作时间更短.两者远期预后相似,临床需根据病变特点个体化选择术式.
Objective To analyze the efficacy of thrombectomy with aspiration and stent thrombectomy in the treatment of acute occlusion of the M1 segment of the middle cerebral artery.Methods A retrospective analysis was conducted on the clinical data of 60 patients with early acute large vessel occlusion cerebral infarction who underwent emergency interventional treatment at the Stroke Center of The First Hospital Affiliated to Qiqihar Medical College from January 2020 to November 2025.According to different surgical methods,the patients were divided into the direct aspiration technique group(28 cases)and the stent thrombectomy group(32 cases).The surgical-related indicators(first thrombectomy recanalization rate,puncture to surgery completion time,etc.),complications(iatrogenic dissection,vasospasm,etc.)and clinical prognosis scores were compared between the two groups.Results The first thrombectomy recanalization rate and the success rate of the first thrombectomy device in the direct aspiration technique group were lower than those in the stent thrombectomy group,the incidence of vasospasm was higher than that in the stent thrombectomy group,the time from puncture to the end of the operation was shorter than that in the stent this mbectomy group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in the final vascular recanalization rate,the incidence of symptomatic intracranial hemorrhage,and the 90-day modified Rankin scale score between the direct aspiration technique group and the stent thrombectomy group(P＞0.05).The total complication rate in the stent thrombectomy group was lower than that in the aspiration thrombectomy group,and the difference was statistically significant(P＜0.05).Conclusion The stent thrombectomy technique has a higher rate of reperfusion after the first attempt in the treatment of acute middle cerebral artery M1 segment occlusion,but the aspiration thrombectomy technique takes less operation time.The long-term prognosis of both is similar.In clinical practice,the surgical method should be selected on an individualized basis according to the characteristics of the lesion.
廉亚东;王晓宇;王雷;王东霞;陈宇超;刘忠锦
齐齐哈尔医学院附属第一医院神经内科,黑龙江 齐齐哈尔 161000齐齐哈尔医学院附属第一医院神经内科,黑龙江 齐齐哈尔 161000齐齐哈尔医学院附属第一医院神经内科,黑龙江 齐齐哈尔 161000齐齐哈尔医学院附属第一医院神经内科,黑龙江 齐齐哈尔 161000齐齐哈尔医学院附属第一医院神经内科,黑龙江 齐齐哈尔 161000齐齐哈尔医学院附属第一医院神经内科,黑龙江 齐齐哈尔 161000
医药卫生
直接抽吸取栓术支架取栓术大脑中动脉M1 段急性闭塞
Direct aspiration thrombectomyStent retriever thrombectomyMiddle cerebral artery M1 segmentAcute oc-clusion
《中国当代医药》 2026 (12)
30-34,5
黑龙江省齐齐哈尔市科技计划联合引导项目(LHYD-2021078).
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