机械联合动静脉多途径血管再通术治疗急性颅内大动脉闭塞的临床研究

doi:10.3969/j.issn.10073205.2019.06.003

河北医科大学学报

机械联合动静脉多途径血管再通术治疗急性颅内大动脉闭塞的临床研究

河北省邢台市第三医院神经内科，河北邢台 054000

出版日期:2019-06-25 发布日期:2019-06-19
作者简介:王玉（1983-），女，河北邢台人，河北省邢台市第三医院主治医师，医学硕士，从事脑血管疾病诊治研究。
基金资助:
河北省卫生计生委科技成果推广课题（1120140236）

Efficacy analysis of combined mechanical thrombolysis with intravenous and intraarterial thrombolysis in patients with acute intracranial large artery occlusion #br#

Department of Neurology, the Third Hospital of Xingtai, Hebei Province， Xingtai 054000, China

Online:2019-06-25 Published:2019-06-19

摘要/Abstract

摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨机械联合动静脉多途径血管再通术治疗急性颅内大动脉闭塞患者的临床效果及安全性。
〖HTH〗方法〖HTSS〗〖KG*2〗选择急性颅内大动脉闭塞患者38例，其中颈内动脉闭塞患者9例，大脑中动脉闭塞患者18例，基底动脉闭塞患者11例，均采用机械联合动静脉多途径血管再通术治疗，观察其临床效果及安全性。
〖HTH〗结果〖HTSS〗〖KG*2〗根据卒中类型及血管情况，使用机械碎栓3例，动脉溶栓13例，机械取栓23例，球囊扩张3例，支架治疗5例。术后血管再通33例，再通率为86.8%，完全再通22例（57.9%），部分再通11例（28.9%）。术后脑梗死溶栓分级靶血流可达2b～3级。术后症状性颅内出血4例，额叶出血1例，基底节、颞叶出血1例，死亡6例。存活的32例患者治疗后，随时间延长，美国国立卫生研究院卒中量表评分逐渐降低，日常生活能力量表评分逐渐升高，差异有统计学意义（P＜005），出院时改良Rankin量表评分与出院6个月改良Rankin量表评分差异无统计学意义（P＞005）。
〖HTH〗结论〖HTSS〗〖KG*2〗对发病4.5 h内的急性颅内大动脉闭塞患者行机械联合动静脉多途径血管再通术是安全有效的。

关键词: 脑缺血, 机械取栓, 动脉溶栓, 静脉溶栓

Abstract: 〖WTHZ〗［Abstract］〓Objective〖HTSS〗〓To investigate the efficacy and safety of mechanical thrombolysis with intravenous and intraarterial thrombolysis in patinets with acute intracranial large artery occlusion.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓The clinical data of 38 patients with acute intracranial large artery occlusion by using the combined mechanical thrombolysis with intravenous and intraarterial thrombolysis were analyzed retrospectively. There were 9 cases in internal carotid artery,18 cases in middle cerebral artery,11 cases in basilar artery .The clinical effects and safety were analyzed.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓According to the stroke type and vascular condition, mechanical thrombolysis was used in 3 patiens. Arterial thrombolysis was used in 13 patients. Mechanical thrombectomy was used in 23 patients. Balloon dilatation was used in 3 patients. Stenting was used in 5 patients. Occluded large arteries of 33 patients were dredged totally or partialy，the recanalization rate or partial recanalization rate of blocked blood vessel was 86.8%,including 22 cases with total recanalization(57.9%),11 cases with partial recanalization(28.9%). The target blood flow evaluated by modified thrombolysis in cerebral infarction can reached form 2b-3 grade. After operation four cases suffered from cerebralhemorrhage，including 1 case of frontal lobe hemorrhage, 1 case of basal ganglia and temporal lobe hemorrhage,6 cases died． 32 patients were survived from treatment. Over time,the ranks of National Institute of Health Stroke Scale gradually decreased, the ranks of Activity of Daily Living Scale gradually increased, and the difference was statistically significant(P＜0.05). The degree of modified Rankin Scale showed no significant difference between leaving and 6 months after departure from the hospital(P＞0.05).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓Mechanical thrombolysis with intravenous and intraarterial thrombolysis in patinets with acute intracranial large artery occlusion is a safe and an effective therapy within 4.5 h intravenous thrombolysis time window．

Key words: brain ischemia； mechanical thrombectomy, intraarterrial thrombolysis, intravenous thrombolysis

王〓玉，吴力娟，许英冬，李国锋，李晓强，魏玉清*. 机械联合动静脉多途径血管再通术治疗急性颅内大动脉闭塞的临床研究[J]. 河北医科大学学报, doi: 10.3969/j.issn.10073205.2019.06.003.

WANG Yu， WU Lijuan, XU Yingdong， LI Guofeng, LI Xiaoqiang, WEI Yuqing*. Efficacy analysis of combined mechanical thrombolysis with intravenous and intraarterial thrombolysis in patients with acute intracranial large artery occlusion #br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.10073205.2019.06.003.

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机械联合动静脉多途径血管再通术治疗急性颅内大动脉闭塞的临床研究

Efficacy analysis of combined mechanical thrombolysis with intravenous and intraarterial thrombolysis in patients with acute intracranial large artery occlusion #br#

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