Solitaire AB支架取栓术治疗急性大脑中动脉闭塞的护理体会

Abstract

目的：探讨Solitaire AB支架用于急性大脑中动脉闭塞(acute middle cerebral artery occlusion, AMCAO)动脉内取栓的疗效及护理。方法：回顾性分析安庆市第一人民医院2015年5月~2017年6月，23例采用Solitaire AB支架行急性大脑中动脉闭塞取栓术患者的临床资料。比较患者治疗前后美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale, NIHSS)评分及术后90 d mRS评分，评估患者预后状况。结果：患者血管成功再通(mTICI ≥ 2b) 20例(86.95%)，术后NIHSS评分改善 ≥ 15分；入院时NIHSS评分(18.81 ± 6.83)分，出院时NIHSS评分(2.50 ± 3.34)分，3例部分再通，90 d随访临床结局优良，失访1例；结论：对急性大脑中动脉栓塞的患者，使用Solitaire AB支架取栓术是相对安全的,可提高血管再通率，改善临床预后，其预后及转归与护理是否正确密切相关。 Objective: To explore and evaluate the efficacy and safety of mechanical thrombectomy with the Solitaire AB Revascularization Device in patients with acute middle cerebral artery occlusion (AMCAO). Methods: Twenty-three patients with middle cerebral artery occlusion were treated with using Solitaire AB stent retrievers between May 2015 and June 2017 in the First People’s Hospital of Anqing. Neurologic status was evaluated before and after treatment according to the National Institutes of Health Stroke Scale (NIHSS), and modified Rankin Score (mRS) 90 days after stent placement. Results: Twenty patients (86.95%) had successful recanalization (TICI ≥ 2b), NIHSS improvement ≥ 15 points was reached in twenty patients. NIHSS score (18.81 ± 6.83) at admission, NIHSS score at discharge (2.50 ± 3.34), twenty patients had a favorable clinical outcome in the 90 d follow-up (mRS ≤ 1), three patients of partial recanalization. One patient was followed up. Conclusion: Mechanical thrombectomy with the Solitaire AB stent in acute middle cerebral oc-clusion is relatively safe, improved vascular recanalization rated and clinical prognosis.