急诊支架手术治疗对急性脑卒中患者预后影响的研究

doi:doi:10.3969/j.issn.1002-1949.08.015

Chinese Journal of Critical Care Medicine

Effect of emergency stent surgery on the prognosis of patients with acute stroke

He Guo-jun, Du Ya-hui, Li Xu-dong

Department of Cerebrovascular Disease, the First Affiliated Hospital of Tianjin University of TCM, Tianjin 300193, China

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Abstract Objective A retrospective analysis was conducted to compare the clinical characteristics and prognosis of patients with anterior circulation large vessel occlusion (LVO) who failed mechanical thrombectomy (MT) and received emergency stent treatment with those who did not receive emergency stent treatment, and to evaluate the related factors of good prognosis of patients with failed MT treatment. Methods A total of 461 acute stroke patients who underwent emergency treatment in the intensive care unit of the Department of Cerebrovascular Diseases, the First Affiliated Hospital of Tianjin University of TCM and the Department of Neurosurgery, Tianjin Huanhu Hospital from January 2014 to December 2018 were enrolled. According to the prognosis of patients ( n =116) with failed MT treatment, the patients were divided into a good prognosis group ( n =32) and a poor prognosis group ( n = 84). Univariate and multivariate Logistic regression analysis were used to evaluate the independent prognostic factors. Results The proportion of patients with good prognosis ( t =3.729, P <0.001) in hypertensive patients ( χ 2=12.251, P <0.001), the proportion of patients with distal ICA occlusion ( χ 2=5.830, P=0.016), admission NIHSS score ( t =2.744, P = 0.007 ) was significantly lower than the poor prognosis group, and the proportion of patients with emergency stent treatment surgery ( χ 2=6.798 , P =0.009) was significantly improved. Multivariate Logistic regression analysis showed that emergency stent treatment was an independent prognostic factor for patients with MT failure ( OR = 3.381 , 95% CI 1.177-9.669, P =0.023). Conclusion Emergency stent surgery can significantly improve the recanalization rate and good prognosis rate of patients with failed acute lung stroke due to MT treatment, and will not increase the mortality rate and sICH incidence rate. Emergency stent treatment is an independent and relevant factor for the prognosis of patients, which is worthy of clinical application.

Key words： Mechanical thrombectomy (MT) Large vessel occlusion (LVO) Stent surgery Stroke Prognosis

About author:: He Guo-jun, E-mail: heguojuntj@sohu.com

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He Guo-jun,Du Ya-hui,Li Xu-dong. Effect of emergency stent surgery on the prognosis of patients with acute stroke[J]. Chinese Journal of Critical Care Medicine, 2019, 39(8): 778-783.

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http://www.cnemergency.org.cn/EN/doi:10.3969/j.issn.1002-1949.08.015 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I8/778

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