| Objectives To explore the related factors that affect the short-term and long-term prognosis of patients with acute ischemic stroke who underwent mechanical thrombectomy.Methods A retrospective analysis of the medical records of 86 patients with acute ischemic stroke admitted to the Neuro Intensive Care Unit of the Affiliated Hospital of North China University of Science and Technology from October 2018 to December 2020.According to the difference between the NIHSS score at the time of admission and the NIHSS score at 7 days postoperatively,they were divided into a group with a good shortterm prognosis and a group with a poor short-term prognosis.Patients were classified as good long-term prognosis based on the 90-day modified Rankine Score(m RS)after mechanical thrombectomy.Group and long-term poor prognosis group.The gender,age,smoking history,drinking history and medical history of the above-mentioned patients in each group,as well as the NIHSS score of admission,the location of the vascular occlusion(internal carotid artery or cerebral artery),intraoperative status and blood glucose status(blood glucose changes)Clinical data such as stress level,high blood sugar rate caused by stress,compensation of collateral circulation,successful recanalization time,successful vascular opening number,postoperative bleeding transformation and other clinical data were analyzed univariate analysis,univariate analysis Medium P<0.05.Multivariate Logistic regression analysis included indicators to determine the independent factors affecting the short-term and long-term prognosis of patients.Results 1 The average NIHSS at admission was 19 points,the short-term prognosis rate was 34.22%(30 cases),and the long-term prognosis rate was 54.65%(47 cases).2According to the difference between the NIHSS score at the time of admission and the NIHSS score 7 days after the operation,the patients were divided into a short-term prognosis group(difference≥4 points,30 cases)and a short-term poor prognosis group(difference<4 points,56 cases).Gender,smoking behavior,drinking behavior,previous diabetes,hypertension,atrial fibrillation,use of tirofiban during surgery,bridging therapy,frequency of thrombus removal,method of anesthesia,postoperative intracranial hemorrhage change,occlusion position,Whether the vessel is recanalized(P=0.241,P=0.586,P=0.119,P=0.489,P=0.055,P=0.322,P=0.930,P=0.288,P=0.898,P=0.375,P=0.163,P=0.820,P=0.183)was not statistically significant.Age,NIHSS score at admission,collateral balance,stress hyperglycemia rate,blood glucose variability and recanalization time(P=0.007,P=0.000,P=0.000,P=0.027,P=0.003,P=0.000),the differences are statistically significant.Taking the index of P<0.05 in the univariate analysis as the independent variable and the short-term prognosis as the dependent variable,the confounding factors such as age were excluded.The admission NIHSS score,collateral circulation compensation and recanalization time(OR=1.125;P=0.003,OR=0.291;P=0.012,OR=1.057;P=0.001)were still related to the short-term prognosis.3 According to the results of the modified 90-day Rankin Scale(m RS)after mechanical thrombectomy,patients were divided into a long-term good prognosis group(0-2 points,47 cases)and a long-term poor prognosis group(3-6 points,39 cases).According to gender,history of smoking,history of drinking,previous diabetes,atrial fibrillation,use of tirofiban during surgery,frequency of thrombus removal,method of anesthesia and location of occlusion,the two groups of patients were classified(P=0.561,P=0.265,P=0.287,P=0.132,P=0.187,P=0.067,P=0.935,P=0.356,P=0.667)The difference was not statistically significant.Age,history of hypertension,NIHSS score,admission,bridging therapy,collateral circulation compensation,postoperative intracranial hemorrhage,stress hyperglycemia rate,blood glucose variability,successful vascular opening and recanalization time(P=0.005,P=0.000,P=0.000,P=0.029,P=0.000,P=0.012,P=0.004,P=0.000,P=0.037,P=0.000)The differences were statistically significant.In univariate analysis,the index of P<0.05 was taken as independent variable,and the long-term prognosis was taken as dependent variable.Confounding factors such as age were excluded.NIHSS score,collateral circulation compensation,blood glucose variability,successful revascularization and transformation of intracranial hemorrhage after operation(OR=1.172;P=0.013,OR=0.143;P=0.000,OR=14.696;P=0.01,OR=14.696;P=0.01,OR=0.048;P= 0.031)were still related to the long-term prognosis.Conclusions 1 Low NIHSS value,good collateral circulation,and shortened recanalization time are independent predictors of good short-term prognosis for patients with acute ischemic stroke treated by mechanical thrombectomy.2 Low NIHSS value,good compensation for collateral circulation,low blood glucose variability and successful recanalization of blood vessels are good long-term prognosis for patients receiving acute ischemic stroke treatment Mechanical thrombectomy will be performed sign Postoperative intracranial hemorrhage was transformed into an independent risk factor for long-term poor prognosis.Figure 0;Table 14;Reference 159... |
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