Multiple Factors Analysis Of Affect Cerebral Infarction With Artery Embolectomyand The Study Of TCM Syndrome Distribution Regularity

ObjectiveAnalysis of factors related to arterial ultra early cerebral embolectomy early neurological outcome and prognosis,and to investigate the correlation between the different pathogenic factors and prognosis,and the correlation between the TCM syndromes and the curative effect was summed up to provide reference for the diagnosis and treatment of the combination of Chinese and Western medicine in the super early stage of cerebral infarction..MethodsThe clinical data of ultra early cerebral infarction patients admitted to Guangdong Province Traditional Chinese Medical Hospital from January 2012 to September 2017 were retrospectively analyzed,including age,sex,smoking history,drinking history,basic disease,onset to the interval of starting thrombectomy,NIHSS score before thrombectomy,pre thrombus systolic pressure,and blood glucose level before thrombectomy.The changes of early outcome,long-term prognosis,bleeding transformation and TCM syndrome factors were evaluated after arterial thrombectomy,and the correlation between the above factors and the effect of arterial thrombectomy was analyzed by two yuan Logistic regression.The resultsA total of 141 patients were enrolled in this study,including 91(64.5%)Male,50(35.5%)female.Intraoperative vascular opening in 133(94.3%)cases,early good outcome in 81(57.4%)cases,good prognosis in 68(48.2%)cases,Hemorrhagic transformation was seen in 16(11.3%)cases,symptomatic intracranial hemorrhage in 10(7.1%)cases,and death in 27(19.1%)cases.(1)compared with the bad outcome,the blood glucose level,male and smoking differences before thrombectomy were statistically significant(P =<0.05).The above factors may cause adverse early outcome,and binary Logistic analysis suggested that the blood glucose level before thrombectomy(OR=0.81,95% CI:0.69~0.94,P =0.007)and smoking(OR=2.79,95%CI:1.28~6.10,P =0.010)is an independent risk factor for early adverse outcomes.There was no significant difference in age and blood pressure after stratification(P >0.05).(2)compared with bad prognosis,the NIHSS score before thrombectomy,blood glucose level before thrombectomy,male and drinking differences were statistically significant(=<0.05),The above factors may cause adverse long-term prognosis.Binary Logistic analysis suggested that the pre thrombolytic NIHSS score(OR=1.07,95%CI:1.02 ~ 1.13,P =0.007),and pre-thrombolytic blood glucose level(OR=1.30,95%CI:1.09~1.55,P =0.004)were independent risk factors for bad prognosis.The results of the stratified analysis of age and blood pressure showed that there was no significant difference between the blood pressure level and the early outcome(P =0.151>0.05),and the difference of long-term prognosis was statistically significant(P =0.07< 0.05)age from 60 to 80 has the greatest impact on long-term prognosis.It was found that there were 59(41.8%)cases of CISS type central thromboembolism and 63(44.7%)cases of large atherosclerosis,of which the carrier artery clogged perforator artery was 39(27.7%).There was no significant difference between the different etiological factors and the short-term outcome and the long-term prognosis(P >0.05),which may be related to the smaller sample size.Binary Logistic analysis suggested that males were independent risk factors for hemorrhagic transformation after arterial thrombectomy(OR=3.11,95%CI:1.04 to 9.33,=0.043).The analysis of TCM syndrome factors showed that the wind syndrome,phlegm syndrome and blood stasis syndrome were the three main syndromes of the patients before the thrombectomy.After the treatment of 7d,the positive syndrome(wind syndrome,fire syndrome,phlegm syndrome and blood stasis syndrome)gradually decreased,while the deficiency syndrome(Qi deficiency syndrome and yin deficiency yang hyperactivity syndrome)gradually increased,but the phlegm syndrome and blood stasis syndrome were throughout the acute period;There was no significant difference in the distribution of TCM syndrome factors with the short-term and long-term effects(P <0.05).ConclusionArterial thrombectomy is effective in the treatment of super early cerebral infarction,but the safety needs to be improved.In the early outcome,the blood glucose level before thrombectomy and smoking is an independent risk factor for the adverse outcome of arterial thrombectomy.In the long term prognosis,the NIHSS score before thrombectomy and the level of blood glucose before thrombectomy are independent risk factors for the poor prognosis of the arterial thrombectomy;men are the risk factors for the poor prognosis of the arterial thrombectomy.The risk factors of hemorrhage transformation after arterial thrombectomy.The most atherosclerotic type in CISS typing is the most.There is no significant difference in the difference between the short term,the long term and the CISS typing and the large atherosclerosis.The main factors of TCM syndrome in the ultra early stage of cerebral infarction are empirical evidence,and the deficiency syndrome is the least.With the development of the disease,the two are in the opposite direction,but the phlegm and blood stasis syndrome throughout the acute period.