血管内取栓治疗急性后循环缺血性脑卒中临床分析

目的探讨血管内取栓治疗急性后循环缺血性脑卒中的安全性及有效性。方法回顾性收集东莞人民医院卒中中心2017-06—2019-12收治的18例急性椎基底动脉闭塞患者的基线资料及临床资料,术后90 d对患者进行随访。采用改良Rankin量表(mRS)评估患者的临床预后,并根据mRS评分将患者分为预后良好组(mRS 0~2分)及预后不良组(mRS 3~6分),进行单因素分析影响急性椎基底动脉闭塞取栓患者临床预后的相关因素。结果18例患者取得成功再通15例(83.3%),获得良好预后10例(55.5%)。取得良好预后组患者其发病至股动脉穿刺时间更短(t=-2.192,P=0.044),术前NIHSS评分(Z=-2.408,P=0.016)及术后24 h NIHSS评分(Z=-3.560,P=0.000)更低,ASTIN/SIR评分(Z=-2.253,P=0.024)及BATMAN评分(Z=-3.319,P=0.001)更高。结论血管内取栓治疗急性后循环缺血性脑卒中安全有效,发病至股动脉穿刺时间、术前NIHSS评分及侧支循环评分(ASTIN/SIR评分及BATMAN评分)与良好功能预后相关。

Clinical analysis of intravascular thrombectomy for acute posterior circulation ischemic stroke

Objective To investigate the safety and effectiveness of intravascular thrombectomy in the treatment of acute posterior circulation ischemic stroke.Methods The baseline data and clinical data of 18 patients with acute vertebrobasilar artery occlusion admitted to the Stroke Center of Dongguan People's Hospital from June 2017 to December 2019 were collected retrospectively.Patients were followed up 90 days after operation.The modified Rankin Scale(MRS)was used to evaluate the clinical prognosis of patients.Patients were divided into good prognosis group(mRS 0-2 points)and poor prognosis group(mRS 3-6 points)according to the MRS score.The related factors affecting the clinical prognosis of patients with acute vertebrobasilar artery occlusion thrombectomy were analyzed by single factor analysis.Results Of the 18 patients,15(83.3%)were successfully recanalized and 10(55.5%)had good prognosis.Compared with patients with poor prognosis,patients with good prognosis have shorter onset time to femoral artery puncture(t=-2.192,P=0.044),lower preoperative NIHSS score(Z=-2.408,P=0.016)and 24-hour postoperative NIHSS score(Z=-3.560,P=0.000),higher ASTIN/SIR score(Z=-2.253,P=0.024)and BATMAN score(Z=-3.319,P=0.001).Conclusion Intravascular thrombectomy is safe and effective in the treatment of acute posterior circulation ischemic stroke.The time from onset to femoral artery puncture,preoperative NIHSS score and collateral circulation score(ASTIN/SIR score and BATMAN score)are related to good functional prognosis.