中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2014年
6期
610-613
,共4页
景英朝%姚晓腾%郑定柯%刘克君%谢乙团%荆国杰
景英朝%姚曉騰%鄭定柯%劉剋君%謝乙糰%荊國傑
경영조%요효등%정정가%류극군%사을단%형국걸
急性缺血性脑卒中%动脉溶栓%机械碎栓%支架拉栓
急性缺血性腦卒中%動脈溶栓%機械碎栓%支架拉栓
급성결혈성뇌졸중%동맥용전%궤계쇄전%지가랍전
Acute cerebral stroke%Arterial thrombolysis%Mechanical fragmengation%Stent thrombectomy
目的 分析血管内介入治疗急性缺血性脑卒中的疗效. 方法 惠州市第一人民医院神经外科自2010年1月至2013年10月采用血管内介入治疗急性缺血性脑卒中患者32例(大脑中动脉闭塞22例,颈内动脉闭塞10例),其中重组组织型纤溶酶原激活剂(r-tpA)及尿激酶动脉溶栓+碎栓14例,溶栓+碎栓+Solitaire支架拉栓18例.回顾性分析患者的临床资料和疗效,总结并发症的预防经验. 结果 本组患者复查头颅CT显示血管完全再通18例,部分再通5例,未再通9例.血管再通率为71％.术后发生症状性脑出血2例(6％),发生大面积脑梗死1例(3.1％).1月后复查MRI脑梗死范围均有所缩小.患者美国国立卫生院神经功能缺损评分(NIHSS)4～6分,预后良好23例(72％),9例患者遗留较重神经功能障碍,肢体肌力小于Ⅲ级. 结论 血管内介入治疗急性缺血性脑卒中患者,可达到较高的血管再通率、获得较好疗效.
目的 分析血管內介入治療急性缺血性腦卒中的療效. 方法 惠州市第一人民醫院神經外科自2010年1月至2013年10月採用血管內介入治療急性缺血性腦卒中患者32例(大腦中動脈閉塞22例,頸內動脈閉塞10例),其中重組組織型纖溶酶原激活劑(r-tpA)及尿激酶動脈溶栓+碎栓14例,溶栓+碎栓+Solitaire支架拉栓18例.迴顧性分析患者的臨床資料和療效,總結併髮癥的預防經驗. 結果 本組患者複查頭顱CT顯示血管完全再通18例,部分再通5例,未再通9例.血管再通率為71％.術後髮生癥狀性腦齣血2例(6％),髮生大麵積腦梗死1例(3.1％).1月後複查MRI腦梗死範圍均有所縮小.患者美國國立衛生院神經功能缺損評分(NIHSS)4～6分,預後良好23例(72％),9例患者遺留較重神經功能障礙,肢體肌力小于Ⅲ級. 結論 血管內介入治療急性缺血性腦卒中患者,可達到較高的血管再通率、穫得較好療效.
목적 분석혈관내개입치료급성결혈성뇌졸중적료효. 방법 혜주시제일인민의원신경외과자2010년1월지2013년10월채용혈관내개입치료급성결혈성뇌졸중환자32례(대뇌중동맥폐새22례,경내동맥폐새10례),기중중조조직형섬용매원격활제(r-tpA)급뇨격매동맥용전+쇄전14례,용전+쇄전+Solitaire지가랍전18례.회고성분석환자적림상자료화료효,총결병발증적예방경험. 결과 본조환자복사두로CT현시혈관완전재통18례,부분재통5례,미재통9례.혈관재통솔위71％.술후발생증상성뇌출혈2례(6％),발생대면적뇌경사1례(3.1％).1월후복사MRI뇌경사범위균유소축소.환자미국국립위생원신경공능결손평분(NIHSS)4～6분,예후량호23례(72％),9례환자유류교중신경공능장애,지체기력소우Ⅲ급. 결론 혈관내개입치료급성결혈성뇌졸중환자,가체도교고적혈관재통솔、획득교호료효.
Objective To evaluate the effectiveness of endovascular intervention in treating acute cerebral stroke.Methods Thirty-two patients with acute cerebral stroke (22 with middle cerebral artery occlusion and 10 with internal carotid artery occlusion),admitted to and treated with endovascular intervention in our hospital from January 2010 to October 2013,were chosen in our study;14 were performed arterial thrombolysis+mechanical fragrnengation and 18 were performed mechanical fragrnengation+ solitaireAB stent thrombectomy.Retrospective analysis was performed on the clinical data and treatment efficacy,and the prevention experience of complications was concluded.Results CTA showed that complete recanalization was noted in 18 patients and partial recanalization in 5,with a recanalization rate reaching 7 1％.Postoperative symptomatic intracerebral hemorrhage was noted in 2 patients (6％) and 1 (3.1％) had large area of cerebral infarction.One month after the treatment,MRI indicated decreased areas of infarction in all patients.NIHSS scores were 4-6 points of all patients;favorable prognosis was noted in 23 patients (72％).Nine patients had heavy neurological dysfunction,with limb muscle strength less than grade Ⅲ.Conclusion Endovascular intervention in treating acute cerebral stroke can get high recanalization rate,and achieve good clinical outcome.
