抽吸取栓和支架取栓治疗急性缺血性脑卒中的疗效对比分析

目的比较抽吸取栓和支架取栓治疗急性缺血性前循环大血管闭塞的临床效果。 方法回顾性分析普宁市人民医院神经外科自2017年1月至2019年12月采用血管内介入取栓术治疗的97例急性缺血性前循环大血管闭塞患者的临床资料。根据术中采取的取栓技术将患者分为抽吸组和支架组。比较2组患者的基线资料、手术开通效果及预后情况，采用单因素和多因素Logistic回归分析影响出院时预后的独立影响因素。 结果本组纳入的97例急性缺血性前循环大血管闭塞患者中，抽吸组39例，支架组58例，2组患者的血管再通率比较，差异有统计学意义（P>0.05）；出院时，19例（48.7%）抽吸组患者恢复良好，15例（25.9%）支架组患者恢复良好，差异有统计学意义（P<0.05）。多因素分析结果显示高ASPECT评分和抽吸技术是出院时良好预后的独立影响因素。出院后90 d随访，结果显示抽吸组和支架组的预后良好率分别是60.0%和45.8%，差异无统计学意义（P>0.05）。 结论高ASPECT评分和抽吸技术是良好临床结果的独立预测因素。相比支架取栓，抽吸取栓能获得更好的影像学和远期临床结果。

Comparison of therapeutic effects of stent retriever thrombectomy and aspiration thrombectomy for the treatment of acute ischemic stroke

ObjectiveTo compare the clinical efficacy of stent retriever thrombectomy and aspiration thrombectomy in the treatment of acute ischemic stroke. MethodsThe clinical data of 97 patients with acute large vessel occlusion of anterior circulation treated by interventional thrombectomy therapy in Neurosurgery Department of Puning People’s Hospital from January 2017 to December 2019 were retrospectively collected and analyzed. The patients were divided into aspiration group and stent group according to the thrombectomy technique. The baseline data, surgical opening effect and prognosis of the two groups were compared. The independent factors affecting the prognosis at discharge were analyzed by univariate and multivariate logistic regression. ResultsAmong the 97 patients with acute large vessel occlusion of anterior circulation, there were 39 cases in the aspiration group, 58 cases in the stent group. There was significant difference in vascular recanalization rate between the two groups (P>0.05); At discharge, 19 patients (48.7%) in the aspiration group recovered well, and 15 patients (25.9%) in the stent group recovered well (P<0.05). Multivariate analysis showed that high ASPECT score and aspiration technique were independent factors affecting the good prognosis at discharge. Patients were followed up at the 90^th day after discharge, the results showed that the good prognosis rates of aspiration group and stent group were 60.0% and 45.8% respectively, with no significant difference (P>0.05). ConclusionHigh ASPECT score and aspiration technique were independent predictors of good clinical outcomes. Compared with stent retriever thrombectomy, aspiration thrombectomy can obtain better imaging and long-term clinical outcomes.