1 太和县人民医院神经外科，安徽 太和 236600
目的：探讨选用机械取栓给予大血管闭塞性急性缺血性脑卒中(acute ischemic stroke，AIS)患者治疗时对预后产生影响的相关因素。方法：纳入2018年8月到2019年12月在太和县人民医院接受机械取栓治疗的60例AIS患者作为分析对象，根据资料将预后不良25例患者作为不良组，将预后良好35例患者作为良好组，回顾分析影响患者预后的相关因素。结果：单变量分析结果显示：不良组入院至再通时间长于良好组，术前NIHSS评分高于良好组，术前ASPECT评分低于良好组，取栓次数多于良好组，差异比较均有统计学意义(均P<0.05)；不良组中性粒细胞与淋巴细胞比值大于良好组，降钙素原水平高于良好组，差异有统计学意义(均P<0.05)；多因素logistic回归分析结果显示：入院至再通时间、术前NIHSS及ASPECT评分均为影响患者预后的独立危险因素。结论：入院至再通时间及术前NIHSS、ASPECT评分和术后90 d mRS评分、取栓次数均是影响大血管闭塞性AIS患者机械取栓治疗预后的关键因素。
Prognostic factors of mechanical embolectomy in patients with acute ischemic stroke due to occlusion of great vessels
CorrespondingAuthor: ZHAO Shuguang
This work was supported by the Research Project of Fuyang Municipal Health Commission, China (FY2019-101).
Objective: To investigate the effect of mechanical embolectomy on the prognosis of patients with acute ischemic stroke (AIS) due to occlusion of great vessels. Methods: The clinical data of 60 patients with AIS who underwent mechanical embolectomy in our hospital from August 2018 to December 2019 were collected. According to the data, 25 patients with poor prognosis were selected as the poor prognosis group, while 35 patients with good prognosis were selected as the good prognosis group. The factors related to the prognosis of patients were analyzed retrospectively. Results: The results of univariate analysis showed that the time from admission to recanalization in the poor prognosis group was significantly longer than that in the good prognosis group, the NIHSS score before operation in the poor prognosis group were significantly higher than that in the good prognosis group, the ASPECT score before operation was significantly lower than that in the good prognosis group, and the times of embolectomy were significantly higher than that in the good prognosis group (all P<0.05). The neutrophil to lymphocyte ratio and procalcitonin level in the poor prognosis group were significantly higher than those in the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that admission-to-recanalization time, preoperative NIHSS score, preoperative ASPECT score, and embolectomy times were independent risk factors for prognosis (all P<0.05). Conclusion: Admission-to-recanalization time, preoperative NIHSS and ASPECT scores are the key factors affecting the prognosis of AIS patients with mechanical thrombectomy.
occlusion of great vessels; acute ischemia; stroke; mechanical embolectomy; prognosis; influencing factor