支架联合抽吸取栓术治疗老年颅内大血管急性闭塞的疗效观察

目的探讨支架联合抽吸取栓术治疗老年颅内大血管急性闭塞的效果及对患者血流动力学、神经功能和预后的影响。方法选取2016年10月—2019年10月宿州市第一人民医院和贵州医科大学附属医院收治的老年颅内大血管急性闭塞患者62例,按照随机数字表法分为观察组和对照组,每组31例。对照组采用单纯支架取栓,观察组采用支架联合抽吸取栓。比较两组静脉和动脉再通时间和取栓次数;术前和术后3个月神经功能缺损(CSS)评分、Barthel指数量表(BI)评分、颈动脉最小血流量(Qmin)和最小血流速度(Vmin)变化;以及术后3个月预后情况。结果观察组静脉和动脉再通时间长于对照组(P <0.05),取栓次数少于对照组(P <0.05)。观察组手术前后CSS评分、BI评分的差值大于对照组(P <0.05)。观察组手术前后颈动脉Qmin和Vmin的差值大于对照组(P <0.05)。观察组预后良好率高于对照组(P <0.05)。结论支架联合抽吸取栓术治疗老年颅内大血管急性闭塞疗效较好,可改善患者血流动力血管、神经功能及预后。

The curative effect of stent retriever thrombectomy combined with aspiration thrombectomy in the treatment of elderly patients with acute large vessel intracranial occlusion

Objective To investigate the curative effect of stent retriever thrombectomy combined with aspiration thrombectomy in the treatment of elderly patients with acute large vessel intracranial occlusion and its influences on the hemodynamics and neurological function.Methods A total of 62 elderly patients with acute large vessel intracranial occlusion in Suzhou First People''s Hospital and the Affiliated Hospital of Guizhou Medical University from October 2016 to October 2019 were selected and divided into observation group (31 cases) and control group (31 cases) according to the random number table method. The control group was treated with stent retriever thrombectomy alone, and the observation group was treated with stent retriever thrombectomy combined with aspiration thrombectomy. The time to recanalization of intracranial arteries and veins, the number of thrombectomy attempts, the alterations in China Stroke Scal (CSS) score, Barthel Index (BI) score, and minimum blood flow rate (Qmin) and minimum blood flow velocity (Vmin) of carotid artery between baseline before operation and 3 months after operation, and prognosis of the patients at 3 months after operation were compared between the two groups.Results The time to recanalization of intracranial arteries and veins in the observation group was longer than that in the control group (P < 0.05), and the number of thrombectomy attempts was fewer in the observation group than in the control group (P < 0.05). The differences in CSS score, BI score, Qmin and Vmin between baseline before operation and 3 months after operation were greater in the observation group compared with the control group (P < 0.05). The prognosis of the observation group was better than that of the control group (P < 0.05).Conclusions Stent retriever thrombectomy combined with aspiration thrombectomy is effective in the treatment of elderly patients with acute large vessel intracranial occlusion. It can improve the blood flow and neurological function, and therefore the prognosis of the patients.