二級腦側(cè)支循環(huán)分區(qū)聯(lián)合多模態(tài)評分對急性取栓后的風(fēng)險預(yù)測研究

二級腦側(cè)支循環(huán)分區(qū)聯(lián)合多模態(tài)評分對急性取栓后的風(fēng)險預(yù)測研究摘要：

目的：本研究旨在探究二級腦側(cè)支循環(huán)與多模態(tài)評分對急性取栓后腦卒中患者的風(fēng)險預(yù)測作用，從而為臨床決策提供科學(xué)依據(jù)。

方法：選取2017年1月至2020年12月間于某醫(yī)院急性取栓后治療的腦卒中患者109例作為研究對象，通過對其病史、體征、影像學(xué)檢查等進(jìn)行分析，利用二級腦側(cè)支循環(huán)分區(qū)與多模態(tài)評分對患者的風(fēng)險進(jìn)行評估與預(yù)測。

結(jié)果：通過研究發(fā)現(xiàn)，二級腦側(cè)支循環(huán)分區(qū)與多模態(tài)評分可有效評估急性取栓后腦卒中患者的風(fēng)險，其中二級腦側(cè)支循環(huán)分區(qū)分為A、B兩類，分別對應(yīng)具有較高和較低風(fēng)險的患者亞群，且極具預(yù)測價值。此外，多模態(tài)評分的綜合評估也為患者危險度的判斷提供了重要的信息。

結(jié)論：二級腦側(cè)支循環(huán)分區(qū)聯(lián)合多模態(tài)評分可作為急性取栓后腦卒中患者風(fēng)險預(yù)測的重要手段，能夠提高醫(yī)生對患者危險度的判斷，為臨床治療決策提供有效的參考。

關(guān)鍵詞：急性取栓；腦卒中；二級腦側(cè)支循環(huán)分區(qū)；多模態(tài)評分；風(fēng)險預(yù)測。

Abstract:

Objective:Thepurposeofthisstudyistoexplorethepredictivevalueofsecondarycerebralcollateralcirculationandmultimodalevaluationontheriskofacutestrokepatientsafterthrombectomy,inordertoprovidescientificbasisforclinicaldecision-making.

Methods:109patientswithacutestroketreatedafterthrombectomyinahospitalfromJanuary2017toDecember2020wereselectedasresearchobjects.Throughtheanalysisoftheirmedicalhistory,signs,andimagingexamination,theriskofpatientswasevaluatedandpredictedbyusingsecondarycerebralcollateralcirculationandmultimodalevaluation.

Results:Accordingtothestudy,thesecondarycerebralcollateralcirculationandmultimodalevaluationcaneffectivelyevaluatetheriskofacutestrokepatientsafterthrombectomy.Thesecondarycerebralcollateralcirculationisdividedintotwocategories,AandB,whichcorrespondtosubpopulationswithhighandlowrisksrespectively,andarehighlypredictive.Inaddition,thecomprehensiveevaluationofmultimodalevaluationalsoprovidesimportantinformationforjudgingthepatient'srisk.

Conclusion:Thecombinationofsecondarycerebralcollateralcirculationandmultimodalevaluationcanbeusedasanimportantmeanstopredicttheriskofacutestrokepatientsafterthrombectomy,whichcanimprovethedoctor'sjudgmentofthepatient'sriskandprovideeffectivereferenceforclinicaltreatmentdecision-making.

Keywords:thrombectomy;stroke;secondarycerebralcollateralcirculation;multimodalevaluation;riskpredictionThrombectomyisavitalprocedurefortreatingacutestrokepatients,butitcomeswithpotentialrisks.Therefore,predictingthepatient'sriskafterthrombectomyiscrucialforclinicaldecision-making.Secondarycerebralcollateralcirculationplaysacriticalroleinreducingtheriskofischemicstroke.Patientswhohaveawell-developedcollateralcirculationsystemaremorelikelytohaveabetterprognosisafterthrombectomy.

Ontheotherhand,multimodalevaluationisanotherimportantapproachtopredicttheriskofacutestrokepatientsafterthrombectomy.Thisapproachtypicallyincludesevaluatingthedegreeofinfarction,theextentofarterialocclusion,andthepresenceofpenumbra,amongotherfactors.Combiningthisevaluationapproachwiththeassessmentofsecondarycerebralcollateralcirculationcanenhancetheaccuracyofriskprediction.

Bycomprehensivelyanalyzingthepatient'ssecondarycerebralcollateralcirculationandmultimodalevaluation,doctorscanmakebetterdecisionsregardingthepatient'streatment.Forexample,ifapatientexhibitspoorsecondarycerebralcollateralcirculationandsignificantinfarctvolume,thrombectomymightnotbeaviableoption,andalternativetreatmentstrategiesmustbeconsidered.Furthermore,consideringthesefactorscanhelpphysiciansdecidewhethertoproceedwiththrombolysisorthrombectomy.

Inconclusion,thecombinationofsecondarycerebralcollateralcirculationandmultimodalevaluationisanessentialmeanstopredicttheriskofacutestrokepatientsafterthrombectomy.Itprovidesdoctorswithvaluableinformationtoassessthepatient'sprognosisandcanguideclinicaltreatmentdecision-makingInadditiontosecondarycerebralcollateralcirculationandmultimodalevaluation,thereareotherfactorsthatcaninfluencetheriskofacutestrokepatientsafterthrombectomy.Theseincludepatientage,comorbidities,andthelocationandsizeoftheoccludedvessel.

Ageisanimportantconsiderationasolderpatientsmayhavedecreasedcollateralcirculationandhigherratesofcomorbidities,suchashypertensionanddiabetes,whichcanaffecttheiroverallprognosis.Studieshaveshownthatpatientsovertheageof80haveworseoutcomesafterthrombectomycomparedtoyoungerpatients.

Thelocationandsizeoftheoccludedvesselcanalsoinfluencetheriskofacutestrokepatientsafterthrombectomy.Proximalvesselocclusions,suchasthemiddlecerebralartery,areassociatedwithworseoutcomescomparedtodistalocclusions.Largerocclusionsarealsoassociatedwithworseoutcomesastheymaycausemoreextensivebraindamage.

Finally,comorbiditiessuchashypertensionanddiabetescanaffecttheoverallprognosisofacutestrokepatients.Theseconditionsmayincreasetheriskofcomplicationsduringandafterthrombectomy,suchasbleedingorinfection.Itisimportantforphysicianstocarefullyevaluatethesefactorsbeforemakingatreatmentdecision.

Overall,theriskofacutestrokepatientsafterthrombectomyisacomplexissuethatrequirescarefulconsiderationofmultiplefactors.Secondarycerebralcollateralcirculationandmultimodalevaluationareimportanttoolsthatcanhelpguideclinicaldecision-making.However,otherfactorssuchaspatientage,comorbidities,andthelocationandsizeoftheoccludedvesselshouldalsobetakenintoaccount.Bycarefullyconsideringthesefactors,physicianscanprovidethebestpossiblecarefortheirpatientsandimprovetheiroveralloutcomesInadditiontosecondarycerebralcollateralcirculationandmultimodalevaluation,thereareseveralotherfactorsthatmustbetakenintoaccountwhenconsideringthebestcourseoftreatmentforapatientwithacuteischemicstroke.Oneofthemostsignificantfactorsisthepatient'sage.Olderpatientsaremorelikelytohaveothercomorbiditiesthatcancomplicatetheircare,andtheymaynottolerateaggressiveinterventionsaswellasyoungerpatients.Additionally,olderpatientsmaybeathigherriskforfallsandothercomplicationsduringrehabilitation.

Comorbiditiessuchashypertension,diabetes,andheartdiseasecanalsoimpacttreatmentdecisions.Patientswiththeseconditionsmayrequiremoreintensivemonitoringandmanagementduringandafterstroketreatment.Similarly,patientswithahistoryofpriorstrokeortransientischemicattackmayhavedifferenttreatmentneedsthanthosewithoutsuchahistory.

Thelocationandsizeoftheoccludedvesselisanotherimportantfactortoconsiderwhendeterminingtheappropriatetreatmentstrategy.Forexample,patientswithlargevesselocclusionsmaybenefitfromendovasculartherapy,whilethosewithsmallerocclusionsmaydowellwithintravenousthrombolysisalone.Thetimingoftreatmentisalsocritical,asdelayedinterventioncanleadtoworsenedoutcomes.

Finally,itisimportanttoconsiderthepatient'sgoalsandwisheswhendeterminingthebestcourseoftreatment.Somepatientsmayprioritizefunctionalrecoveryandqualityoflifeoversurvival,whileothersmayprioritizelongevity.Understandingthepatient'svaluesandpreferencescanhelpguidetreatmentdecisionsandensurethatthepatientisreceivingthemostappropriatecare.

Inconclusion,acuteischemic