摘要
Abstract
Objective This study aims to analyze the factors influencing the prognosis of acute cerebral infarction(ACI)patients after intracranial mechanical thrombectomy.Methods A retrospective analysis was conducted on 60 patients with acute cerebral infarction who underwent endovascular mechanical thrombectomy at the People's Hospital of Bo'ai County from January 2019 to January 2024.Based on the modified Rankin Scale assessment of postoperative prognosis at 3 months,patients were divided into a good prognosis group(34 cases)and a poor prognosis group(26 cases).The differences in general clinical data,perioperative indicators,and postoperative complications between the two groups were analyzed,and univariate and multivariate logistic regression analyses were performed to identify the factors associated with prognosis in critically ill acute cerebral infarction patients undergoing mechanical thrombectomy.Results There were significant differences in the history of hypertension,diabetes,and atrial fibrillation between the two groups.The preoperative and postoperative NIHSS scores and ASPECT scores at 24 hours showed statistically significant differences(P＜0.05)while other clinical indicators did not show significant differences(P＞0.05).The surgery time in the good prognosis group was significantly shorter than that in the poor prognosis group,and the incidence of postoperative pulmonary infection and cerebral hemorrhage was lower in the good prognosis group,with significant differences(P＜0.05).There were no statistically significant differences between the two groups regarding onset-to-treatment time,number of thrombectomies,incidence of thrombus escape,and number of successful recanalizations post-thrombectomy(P＞0.05).Further multivariate logistic regression analysis revealed that postoperative NIHSS score at 24 hours,pulmonary infection,and hypertension were risk factors for poor prognosis,while ASPECT score was a protective factor(P＜0.05).Further analysis using receiver operating characteristic(ROC)curves showed the area under the curve(AUC)values for predicting prognosis were 0.640 for NIHSS at 24 hours,0.881 for ASPECT score,0.647 for hypertension,and 0.647 for pulmonary infection,with the combined use of these factors yielding the highest predictive value for patient prognosis(AUC=0.939).Conclusion The 24-hour NIHSS score,ASPECT score,hypertension,and pulmonary infection all impact the prognosis in critically ill acute cerebral infarction patients post-intracranial mechanical thrombectomy.Furthermore,combined assessments of these indicators provide greater predictive value for patient prognosis,suggesting that clinical prediction of prognosis in patients after mechanical thrombectomy can be enhanced through the joint detection of relevant indicators.关键词
急性脑梗死/颅内血管机械取栓术/预后/危险性因素Key words
acute cerebral infarction/intracranial mechanical thrombectomy/prognosis/risk factors分类
医药卫生
