摘要目的 分析比较机械性血栓切除术（MT）治疗失败并接受急诊支架治疗的前循环大血管闭塞（LVO）患者与未接受急诊支架治疗患者的临床特征和预后，评价MT治疗失败患者预后良好的相关因素。方法 采用回顾性分析，选取2014年1月至2018年12月在天津中医药大学第一附属医院脑血管病科和天津市环湖医院神经外科重症监护室(ICU)进行急诊治疗的461急性脑卒中患者。根据MT（ n =116）治疗失败患者的预后情况，将患者分为预后良好组（ n =32）与预后不良组（ n =84），采用单变量与多变量Logistic回归分析评价患者预后良好的独立相关因素。结果 预后良好组患者年龄（ t = 3.729，P ＜0.001），高血压患者比例（ χ 2=12.251， P ＜ 0.001 ）、远端颈内动脉（ICA）闭塞患者比例（ χ 2=5.830，P=0.016）、入院NIHSS评分（ t =2.744，P= 0.007）较预后不良组明显降低，急诊支架手术患者比例明显增加（ χ 2=6.798， P =0.009）。多变量Logistic回归分析表明，急诊支架治疗是MT失败患者预后良好的独立相关因素（ OR = 3.381 ，95% CI 1.177～9.669， P=0.023）。结论 急诊支架治疗手术可以明显提高因LVO发生急性脑卒中进行MT治疗失败患者的再通率和良好预后率，不会增加患者的病死率和症状性脑出血（sICH）的发生率。急诊支架手术是患者预后良好的独立相关因素，值得临床推广应用。
何国军，杜亚辉，李旭东. 急诊支架手术治疗对急性脑卒中患者预后影响的研究[J]. 中国急救医学, 2019, 39(8): 778-783.
He Guo-jun, Du Ya-hui, Li Xu-dong. Effect of emergency stent surgery on the prognosis of patients with acute stroke. Chinese Journal of Critical Care Medicine, 2019, 39(8): 778-783.
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