[1]李振宇 孟华星 李作鹏 张 金.麻醉方式对不配合的急性颅内前循环闭塞病人机械取栓术的影响[J].中国临床神经外科杂志,2020,(05):280-282.[doi:10.13798/j.issn.1009-153X.2020.05.008]
 LI Zhen-yu,MENG Hua-xing,LI Zuo-peng,et al.Effect of anesthesia on mechanical thrombectomy in uncooperative patients with acute anterior circulation occlusion[J].,2020,(05):280-282.[doi:10.13798/j.issn.1009-153X.2020.05.008]
点击复制

麻醉方式对不配合的急性颅内前循环闭塞病人机械取栓术的影响()
分享到:

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2020年05期
页码:
280-282
栏目:
论著
出版日期:
2020-05-25

文章信息/Info

Title:
Effect of anesthesia on mechanical thrombectomy in uncooperative patients with acute anterior circulation occlusion
文章编号:
1009-153X(2020)05-0280-03
作者:
李振宇 孟华星 李作鹏 张 金
030001 太原,山西医科大学第一临床医学院(李振宇);030001 太原,山西医科大学第一医院神经内科(孟华星、李作鹏、张 金)
Author(s):
LI Zhen-yu1 MENG Hua-xing2 LI Zuo-peng2 ZHANG Jin2.
1. The First Clinical Medical College, Shanxi Medical University, Taiyuan 030001, China; 2. Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan 030001, China
关键词:
急性缺血性脑卒中颅内前循环机械取栓术麻醉方式
Keywords:
Acute ischemic stroke Anterior circulation occlusion Mechanical thrombectomy Anesthesia method
分类号:
R 743.3; R 815.2
DOI:
10.13798/j.issn.1009-153X.2020.05.008
文献标志码:
A
摘要:
目的 探讨全身麻醉(GA)与镇静麻醉(SA)对不合作的急性颅内前循环闭塞机械取栓术的影响。方法 回顾性分析2017年1月至2019年5月收治的41例急性颅内前循环闭塞的临床资料。接受静脉溶栓桥血管内治疗或直接血管内治疗,但病人因躁动、失语、谵妄等不能配合治疗,其中21例采用GA(GA组例),20例采用SA(SA组)。结果 两组穿刺至再通时间、入院至再通时间、取栓次数、血管再通率、术后7 d NIHSS评分、症状性颅内出血率、病死率均无明显差异(P>0.05)。GA组1次再通率、发病90 d预后良好率均明显高于SA组(P<0.05)。结论 对于急性颅内前循环大血管闭塞,如果病人不能配合机械取栓术,相比SA,GA可提高1次再通率,有利于远期神经功能恢复,而且安全性相似
Abstract:
Objective To explore the effects of general anesthesia (GA) and sedation anesthesia (SA) on mechanical thrombectomy in uncooperative patients with acute anterior circulation occlusion. Methods The clinical data of 41 patients with acute anterior circulation occlusion who were admitted to our hospital from January 2017 to May 2019 were retrospectively analyzed. The patients received intravenous thrombolysis bridge intravascular treatment or direct intravascular treatment, but the patients could not cooperate with the treatment due to agitation, aphasia, delirium, etc. Of these 41 patients, 21 patients received GA (GA group) and 20 patients received SA (SA group). Results There was no significant difference in the time from puncture to recanalization, the time from admission to recanalization, the number of thrombectomy, the rate of vascular recanalization, the NIHSS score 7 days after the operation, the rate of symptomatic intracranial hemorrhage, and the mortality between the two groups (P>0.05). The recanalization rate of one operation and the rate of good prognosis at 90 days in the GA group were significantly higher than those in the SA group (P<0.05). Conclusion If the patient with acute anterior circulation occlusion can not cooperate with mechanical thrombectomy, the GA can increase the recanalization rate compared with the SA, which is helpful to the long-term neural function recovery. The safety is similar between the GA and the SA

参考文献/References:

[1] Brinjikji W, Pasternak J, Murad MH, et al. Anesthesia- related outcomes for endovascular stroke revascularization: a systematic review and meta-analysis [J]. Stroke, 2017, 48 (10): 2784-2791.
[2] 朱金钊,张建刚,杨清成,等. 一期支架置入补救治疗急性 后循环大动脉闭塞机械取栓术失败病人的疗效[J]. 中国 临床神经外科杂志,2019,24(9):531-534.
[3] 王 英,杜丽英. 完善绿色通道及取栓流程对急性缺血性 脑卒中病人神经功能的影响[J]. 中国临床神经外科杂 志,2019,24(12):769-771.
[4] 赵文可,张鹏飞,黄昌恒,等. 支架取栓技术与接触抽吸技 术治疗急性颅内大血管闭塞的Meta分析[J]. 中国临床神 经外科杂志,2018,23(6):388-391.
[5] 朱青峰,贾 静,解新民,等. 多种技术在急性脑梗死机械 取栓术中应用效果分析[J]. 中国临床神经外科杂志, 2019,24(10):619-621.
[6] Pfaff JAR, Sch?nenberger S, Nagel S, et al. Effect of general anesthesia versus conscious sedation for stroke thrombec- tomy on angiographic workflow in a randomized rrial: a post hoc analysis of the SIESTA Trial [J]. Radiology, 2017, 286 (3): 1016-1021.
[7] Herrick IA, Gelb AW, Nichols B, et al. Patient-controlled propofol sedation for elderly patients: safety and patient attitude toward control [J]. Can J Anaesth, 1996, 43(10): 1014-1018.
[8] Zhang Y, Jia L, Fang F, et al. General anesthesia versus conscious sedation for intracranial mechanical thrombec- tomy: a systematic review and meta-analysis of randomized clinical trials [J]. J Am Heart Assoc, 2019, 8(12): e011754.
[9] Lin R, Abou-Chebl A, Hussain MS, et al. Conscious seda- tion versus general anesthesia during endovascular therapy for acute anterior circulation stroke: preliminary results from a retrospective, multicenter study [J]. Stroke, 2010, 41 (6): 1175-1179.
[10] L?whagen HP, Rentzos A, Karlsson JE, et al. General anes- thesia versus conscious sedation for endovascular treatment of acute ischemic stroke: The AnStroke Trial (Anesthesia During Stroke) [J]. Stroke, 2017, 48(6): 1601-1607.
[11] Simonsen CZ, Yoo AJ, S?rensen LH, et al. Effect of general anesthesia and conscious sedation during endovascular therapy on infarct growth and clinical outcomes in acute ischemic stroke: a randomized clinical trial [J]. JAMA Neurol, 2018, 75(4): 470-477.

相似文献/References:

[1]韩冰莎 李 娇 李 翔 栗艳茹 张 磊 赵敬河 冯 光.脑氧饱和度监测目标导向治疗在前循环急性缺血性脑卒中机械取栓术后管理的效果[J].中国临床神经外科杂志,2020,(02):73.[doi:10.13798/j.issn.1009-153X.2020.02.004]
 HAN Bing-sha,LI Jiao,LI Xiang,et al.Effects of targeted therapy under direction of monitoring cerebral oxygen saturation on patients with acute ischemic stroke of anterior circulation undergoing mechanical thrombectomy[J].,2020,(05):73.[doi:10.13798/j.issn.1009-153X.2020.02.004]
[2]杨松,周旭,刘敬禹,等.国产药物洗脱支架(Bridge)在颅内前循环血管狭窄中的应用[J].中国临床神经外科杂志,2023,28(08):497.[doi:10.13798/j.issn.1009-153X.2023.08.006]
 YANG Song,ZHOU Xu,LIU Jing-yu,et al.Application of domestic rapamycin eluting stents (Bridgein) in patients with anterior circulation intra-cranial stenosis[J].,2023,28(05):497.[doi:10.13798/j.issn.1009-153X.2023.08.006]

备注/Memo

备注/Memo:
通讯作者:张 金,E-mail:zhj6929@139.com (2019-11-08收稿,2020-01-03修回)
更新日期/Last Update: 1900-01-01