急性缺血性脑卒中机械取栓治疗发生颅内出血化概述.docVIP

急性缺血性脑卒中机械取栓治疗发生颅内出血转化概述 　　[摘要] 急性缺血性卒中（acute ischemic stroke，AIS）是由于供血动脉狭窄或闭塞、脑供血不足导致局限性脑组织缺血坏死出现局灶性神经功能缺损的症状和体征。是导致人类残疾和死亡的主要病因之一，AIS常发生在动脉粥样硬化基础上，形成血栓后导致局部脑组织发生缺血缺氧性坏死，发病急且重，所以AIS治疗的最主要目的是在神经细胞损伤达到不可逆之前，迅速安全地实现闭塞血管再通，以尽可能的恢复血流挽救缺血半暗带组织。中美两国卒中学会相继发布重磅消息，将机械取栓以最高等级，推荐用于急性缺血性卒中患者的救治。相对于溶栓治疗，由于大大减少了溶栓药物的使用，出血并发症相对较低，但出血转化（HT）仍是机械取栓最常见也是最严重的并发症。因此，机械取栓治疗是否出现颅内出血转化将很大程度影响手术的临床效果。该文对目前国内外关于机械取栓症状性颅内出血转化因素研究现状，进行总结阐述，旨在提高手术安全性，降低取栓治疗颅内出血并发症，为最大程度的防治风险提供帮助。 中国论文网 /6/viewhtm　　[关键词] 急性缺血性脑卒中；机械取栓；颅内出血转化 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2018）02（b）-0196-03 　　[Abstract] Acute ischemic stroke （AIS） is a symptom of focal neurological deficit in focal cerebral ischemic necrosis due to stenosis or occlusion of the arterial blood supply， which is the leading cause of human disability and death， AIS often occurs in the basis of atherosclerosis， thrombosis after the formation of ischemic hypoxic necrosis of local brain tissue， the incidence of acute and heavy， so the main purpose of AIS treatment before nerve cell injury reaches irreversible， rapid and safe occlusion of vascular recanalization， in order to restore blood flow as much as possible to save ischemic penumbra tissue. Stroke Society of China and the United States have released heavy news， the mechanical thrombectomy to the highest level， recommended for the treatment of patients with acute ischemic stroke. In contrast to thrombolytic therapy， bleeding complications （HT） remain the most common and serious complications of mechanical thrombectomy， due to the greatly reduced use of thrombolytic drugs and lower bleeding complications. Therefore， the mechanical thrombectomy treatment of intracranial hemorrhage conversion will largely affect the clinical effect of surgery. This paper summarizes the current research on the factors of intracranial hemorrhage of mechanical thrombectomy at home and abroad， and aims to improve the safety of surgery and reduce the complications of intracranial hemorrhage by thrombecto