急性缺血性卒中患者血管内治疗后早期癫痫发作的危险因素分析

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摘要目的探讨急性缺血性卒中患者血管内治疗后早期癫痫发作的相关危险因素。方法回顾性总结南宁市第二人民医院神经内科2019年6月至2021年12月收治的急性缺血性卒中并行血管内治疗患者184例。根据是否并发癫痫发作分为癫痫组36例，非癫痫组148例，分析两组一般情况和可能影响发生癫痫发作的相关因素。采用美国国立卫生研究院卒中量表（NIHSS）评分进行神经功能缺损评估，格拉斯哥昏迷评分（GCS）进行意识障碍程度评估。采用logistic回归分析急性缺血性脑卒中血管内治疗后早期癫痫发作的可能危险因素。结果癫痫组年龄≤65岁、术前NIHSS评分＞11分、术前GCS≤8分、糖尿病、前循环病变、机械取栓和抽吸、出血转化、手术时长＞1 h比例高于非癫痫组（P ＜ 0.05）。多因素logistic回归分析结果显示，术前NIHSS评分＞11分、术前GCS≤8分、机械取栓和抽吸、出血转化、手术时长＞1 h 是血管内治疗的急性缺血性脑卒中并发早期癫痫发作的独立危险因素（P ＜ 0.05）。结论病情严重程度、手术方式、出血转化和手术时长是导致急性期血管内介入治疗患者合并早期癫痫发作的危险因素，值得临床关注。

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	覃百灵李通胡敏婷韦春燕

关键词 ：急性缺血性卒中, 血管内治疗, 早期癫痫发作

Abstract：Objective To investigate the risk factors for early seizures after endovascular therapy for acute ischemic stroke. Methods A retrospective summary was made of 184 patients with acute ischemic stroke who underwent endovascular treatment in the Department of Neurology, Nanning Second People’s Hospital from June 2019 to December 2021. The patients were divided into 36 cases in the epilepsy group and 148 cases in the non-epileptic group according to whether they were complicated with epilepsy. Neurological deficits were assessed using the National Institutes of Health stroke scale (NIHSS) score, and the Glasgow coma scale (GCS) were used to assess the degree of disturbance of consciousness. Logistic regression was used to analyze the possible risk factors of early seizures after endovascular therapy for acute ischemic stroke. Results The proportion of epilepsy group in age ≤65 years old, preoperative NIHSS score＞11 points, preoperative GCS≤8 points, diabetes, anterior circulation lesions, mechanical thrombectomy and aspiration, hemorrhagic transformation, and operation duration＞1 h were higher than those of the non-epilepsy group (P < 0.05). The results of multivariate logistic regression analysis showed that the preoperative NIHSS score＞11 points, preoperative GCS≤8 points, mechanical thrombectomy, hemorrhagic transformation and aspiration, operation time＞1 h were independent risk factors for acute ischemic stroke complicated with early epilepsy after endovascular treatment (P ＜ 0.05). Conclusion Disease severity, surgical method, hemorrhagic transformation and duration of surgery are risk factors for early seizures in patients undergoing endovascular interventional therapy in the acute phase, and it is worthy of clinical attention.

Key words： Acute ischemic stroke Endovascular treatment Early epileptic seizures

基金资助:广西壮族自治区卫生健康委员会科研项目（Z20210233）。

引用本文:

覃百灵李通胡敏婷韦春燕. 急性缺血性卒中患者血管内治疗后早期癫痫发作的危险因素分析[J]. 中国医药导报, 2022, 19(21): 49-52.
QIN Bailing LI Tong HU Minting WEI Chunyan. Analysis of risk factors for early seizures after endovascular therapy for acute ischemic stroke. 中国医药导报, 2022, 19(21): 49-52.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I21/49

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