副arachnoid 出血的程度会影响M2闭塞机械血栓切除术后的临床结果
Fumiaki Oka1, Takuma Nishimoto1, Naomasa Mori1
1Department of Neurosurgery, Yamaguchi Graduate School of Medicine, Ube, Yamaguchi, Japan.
概括
由于M2封闭而进行机械血栓切除术 (MT) 后,厚度下关节出血 (SAH) 与更糟糕的结果有关. 即使成功进行再通道化,显著的SAH也会阻碍恢复并增加死亡率.
科学领域:
- 神经学 神经学
- 干预性神经放射学 干预性神经放射学
- 脑卒中医学 脑卒中医学
背景情况:
- 后机械血栓切除术 (MT) 下关节出血 (SAH) 的预后相关性仍在争论中.
- M2闭塞中风治疗涉及MT,但SAH并发症需要进一步调查.
研究的目的:
- 为了确定SAH凝块厚度是否会影响M2封闭的MT后的临床结果.
- 调查SAH严重程度和MT后的功能恢复之间的关联.
主要方法:
- 对接受M2闭塞的MT患者的前性数据库的回顾性分析.
- 患者根据SAH的存在和厚度进行了分层 (等级0,1,2).
- 跨SAH组的临床和血管学数据和结果的比较.
主要成果:
- 在42%的患者中发生了SAH (N=15/36).
- 厚厚的SAH (2级) 与更多的传球,严重的M2角,24小时NIHSS分数较差 (中位数为14比4) 和较低的有利结局率 (23%比75%) 相关.
- 2级SAH显示90天死亡率显著更高 (25%vs0%).
结论:
- 对于M2封闭的MT后厚厚的SAH预示着不良的临床康复,无论重新道化是否成功.
- 严重的SAH与程序复杂性增加和不良的神经结果有关.
- 厚厚的SAH代表了使用MT治疗M2闭塞中风的显著负面预后因素.
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