急性缺血性脑卒中支架取栓后出血性转化的危险因素分析
Analysis of Risk Factors of Hemorrhagic Transformation after Stent Thrombectomy in Acute Ischemic Stroke
DOI: 10.12677/ACM.2022.126765, PDF,    国家自然科学基金支持
作者: 胡玉奇, 贾 琦, 沈 茜, 代林志, 赵 冬*：石河子大学医学院第一附属医院神经外科，新疆 石河子
关键词: 急性缺血性脑卒中；支架取栓；出血性转化；危险因素；Acute Ischemic Stroke； Stent Thrombectomy； Hemorrhagic Transformation； Risk Factors
摘要: 目的：探讨本卒中中心急性缺血性脑卒中支架取栓术后发生出血性转化的危险因素。方法：收集石河子大学医学院第一附属医院自2018年1月至2020年12月期间急诊行支架取栓的急性缺血性脑卒中201例患者的临床数据资料，根据术后复查头颅CT是否发生出血性转化，分为HT组和非HT组，比较两组患者的基线资料特征，并采用多因素Logistic回归分析影响HT发生的独立危险因素。结果：纳入研究的201例患者中，32人为HT组，169人为非HT组。单因素分析显示两组之间房颤病史、前循环血管闭塞、不良再通、基线NIHSS评分、到院至穿刺时间方面具有统计学差异(P < 0.05)，进行多因素Logistic回归分析，结果显示前循环闭塞、不良再通、较高基线NIHSS评分是急性缺血性脑卒中患者取栓术后发生出血性转化的独立危险因素。结论：对于前循环大血管闭塞、到院至穿刺时间较长、基线NIHSS评分较高、再通不良的患者，在取栓操作后应警惕术后发生出血转化的风险。
Abstract: Objective: To explore the risk factors of hemorrhagic transformation after stent thrombectomy for acute ischemic stroke. Methods: The clinical data of 201 patients with acute ischemic stroke who underwent emergency stent thrombectomy in the first affiliated Hospital of Medical College of Shihezi University from January 2018 to December 2020 were collected and divided into HT group and non-HT group according to the hemorrhagic transformation of CT after operation. The baseline data of the two groups were compared, and the independent risk factors affecting the occurrence of HT were analyzed by multivariate Logistic regression. Results: Among the 201 patients included in the study, 32 patients were in HT group and 169 patients in non-HT group. Univariate analysis showed that there were significant differences in atrial fibrillation history, anterior circulation oc-clusion, poor recanalization, baseline NIHSS score and time from hospital to puncture between the two groups (P < 0.05). Multivariate Logistic regression analysis showed that anterior circulation oc-clusion, poor recanalization and higher baseline NIHSS score were independent risk factors for hemorrhagic transformation in patients with acute cerebral infarction after thrombectomy. Conclu-sion: For the patients with anterior circulation macrovascular occlusion, long time from hospital to puncture, high baseline NIHSS score and poor recanalization, we should pay attention to the risk of postoperative bleeding after thrombectomy.
文章引用：胡玉奇, 贾琦, 沈茜, 代林志, 赵冬. 急性缺血性脑卒中支架取栓后出血性转化的危险因素分析[J]. 临床医学进展, 2022, 12(6): 5278-5285. https://doi.org/10.12677/ACM.2022.126765

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