神经损伤与功能重建2024，Vol.19Issue(4)：206-210,238,6.DOI:10.16780/j.cnki.sjssgncj.20230226
低NIHSS评分的急性前循环大血管闭塞患者血管内治疗的临床研究
Clinical Study on Endovascular Treatment for Acute Anterior Circulation Large Vessel Occlu-sion Patients with Low NIHSS Score
摘要
Abstract
Objective:To explore the effectiveness and safety of endovascular treatment(EVT)in patients with acute anterior circulation large vessel occlusion(ACLVO)and low National Institutes of Health Stroke Scale(NI-HSS)scores at different surgical timings,and to evaluate factors affecting prognosis.Methods:A retrospective collection of clinical data from 89 patients with low NIHSS score(≤5)who underwent emergency EVT for ACLVO at Linyi City People's Hospital Neurology Department from January 2020 to June 2021.Patients were divided into two groups based on their surgical timing:the direct surgery group(42 cases,who received EVT im-mediately after admission followed by standard medical therapy)and the rescue surgery group(47 cases,who ini-tially received standard medical therapy upon admission and underwent emergency endovascular rescue treat-ment if symptoms worsened).The clinical data and outcomes of the two groups were compared.According to the modified Rankin Scale(mRS)score at 90 days post-surgery,patients were divided into a good outcome group(70 cases with mRS ≤2)and a poor outcome group(19 cases with mRS＞2).Univariate and multivariate logis-tic regression analyses were used to identify factors affecting the prognosis of endovascular treatment in patients with low NIHSS score ACLVO.Results:Successful recanalization was achieved in 94.4％(84/89)of patients,and 78.7％(70/89)had a good functional outcome at 90 days.There were 9 cases of neurological deterioration post-surgery,3 cases of symptomatic intracranial hemorrhage,and 3 deaths.Compared to the rescue surgery group,the direct surgery group had a significantly higher proportion of good outcomes at 90 days(90.5％v.s.68.1％,P＜0.05).Preopera-tive low NIHSS score,direct surgical treatment,and high collateral circulation grade were independent predictors of good outcome in EVT for ACLVO patients with low NIHSS scores.Conclusion:EVT may be safe for patients with ACLVO and low NIHSS scores,and early EVT can significantly improve prognosis in these patients.关键词
大血管闭塞/低NIHSS评分/血管内治疗Key words
large vessel occlusion/low NIHSS/Endovascular treatment分类
医药卫生引用本文复制引用
龚字翔,刘基,孙洪扬,于萍,宁召腾,赵璇,朱其义,王贤军..低NIHSS评分的急性前循环大血管闭塞患者血管内治疗的临床研究[J].神经损伤与功能重建,2024,19(4):206-210,238,6.基金项目
临沂市重点研发计划(急性大血管闭塞性轻型卒中血管内治疗的疗效及安全性研究,No.2022YX0002) （急性大血管闭塞性轻型卒中血管内治疗的疗效及安全性研究,No.2022YX0002）
