CAJ | 학술논문

目的观察国产颅内动脉机械装置取栓的有效性及安全性.方法临时阻断颈总动脉血流并注入凝血酶制作60只适合机械取栓的兔急性血管栓塞模型,按随机数字表法分为非治疗组、3h溶栓组、3、6、8、12h取栓组,取栓组应用颅内动脉机械取栓装置取栓,3h溶栓组应用尿激酶溶栓,取、溶栓前后行数字减影血管造影(DSA)观察血管再通,行经颅多普勒(TCD)记录大脑中动脉平均流速(VMCA)变化,行磁共振弥散成像(MR-DWI)描述不同时段取栓表观弥散系数(ADC)的变化.结果 3h取栓、溶栓组的血管再通率分别是80％、20％,差异有统计学意义(P＜0.05),治疗后VMCA的差异有统计学意义(P＜0.05)；非治疗组、12 h取栓组ADC值逐渐降低,而3、6、8h取栓组ADC值逐渐上升；栓塞后24 h与非治疗组和12h取栓组比较,3、6、8h取栓组ADC值较高,差异均有统计学意义(P＜0.05).结论颅内动脉取栓装置取栓有效地提高了闭塞血管的再通率,迅速恢复血流,适当延长了血管内治疗的时间窗.
목적 관찰국산로내동맥궤계장치취전적유효성급안전성.방법 림시조단경총동맥혈류병주입응혈매제작60지괄합궤계취전적토급성혈관전새모형,안수궤수자표법분위비치료조、3h용전조、3、6、8、12h취전조,취전조응용로내동맥궤계취전장치취전,3h용전조응용뇨격매용전,취、용전전후행수자감영혈관조영(DSA)관찰혈관재통,행경로다보륵(TCD)기록대뇌중동맥평균류속(VMCA)변화,행자공진미산성상(MR-DWI)묘술불동시단취전표관미산계수(ADC)적변화.결과 3h취전、용전조적혈관재통솔분별시80％、20％,차이유통계학의의(P＜0.05),치료후VMCA적차이유통계학의의(P＜0.05)；비치료조、12 h취전조ADC치축점강저,이3、6、8h취전조ADC치축점상승；전새후24 h여비치료조화12h취전조비교,3、6、8h취전조ADC치교고,차이균유통계학의의(P＜0.05).결론 로내동맥취전장치취전유효지제고료폐새혈관적재통솔,신속회복혈류,괄당연장료혈관내치료적시간창.
Objective To evaluate the efficacy and sefety of domestic cerebral artery thrombectomy device.Methods The models of acute cerebral artery occlusion in 60 rabbits were established by injecting thrombin while temporary aortic clumping,and randomly divided into 6 groups:non-therapy group,3 h thrombolytic therapy group using urokinase,and 3,6,8,and 12 h mechanical thrombectomy groups.Before and after thrombectomy and thrombolysis,DSA,TCD,VMCA and MR-DWI were performed.Results The percentage of recanalization in the 3 h mechanical thrombectomy group was 80％,significantly higher than that in 3 h thrombolytic therapy group (20％,P ＜ 0.05 ),and there was also statistically significant difference in VMCA ( P ＜ 0.05 ) ; The apparent diffusion coefficient (ADC) was decreased graduately in acute period in non-therapy group and 12 h mechanical thrombectomy group.The ADC was increased gradually in 3,6,8 h mechanical thrombectomy groups and had statistically significant difference from the non-therapy group and 12 h mechanical thrombectomy group at 24 h ( P ＜ 0.05 ).Conclusion Cerebral artery thrombectomy device effectively increases the recallization percentage of cerebral vascularocclusion,recovers blood circulation rapidly and prolongs time windows for endovascular treatment.