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\u80cc\u666f \u8fd1\u5e74\u6765\uff0c\u6709\u5173\u5ef6\u957f\u65f6\u95f4\u7a97\u7684\u8840\u7ba1\u5185\u6cbb\u7597\u7684\u4e34\u5e8a\u8bd5\u9a8c\u4e3a\u8fdf\u53d1\u6027\u5927\u8840\u7ba1\u95ed\u585e\u6027\u8111\u5352\u4e2d\u60a3\u8005\u5f00\u8f9f\u4e86\u65b0\u7684\u6cbb\u7597\u6a21\u5f0f\u3002\u672c\u6307\u5357\u65e8\u5728\u4e3a\u5728\u5ef6\u957f\u65f6\u95f4\u7a97\u5185\u7684\u5927\u8840\u7ba1\u95ed\u585e\u7684\u60a3\u8005\u7684\u8bca\u65ad\u3001\u7b5b\u9009\u548c\u5185\u79d1\u6216\u8840\u7ba1\u5185\u6cbb\u7597\u63d0\u4f9b\u6700\u65b0\u5efa\u8bae\u3002<\/p>\n<\/p>\n
\u65b9\u6cd5 \u8840\u7ba1\u548c\u4ecb\u5165\u795e\u7ecf\u75c5\u5b66\u534f\u4f1a\u6307\u5357\u548c\u5b9e\u8df5\u6807\u51c6\u59d4\u5458\u4f1a\uff08Society of Vascular and Interventional Neurology Guidelines and Practice Standards committee\uff09\u7ec4\u5efa\u4e86\u4e00\u4e2a\u5199\u4f5c\u5c0f\u7ec4\uff0c\u5e76\u62db\u52df\u4e86\u8de8\u5b66\u79d1\u4e13\u5bb6\u6765\u5ba1\u67e5\u548c\u8bc4\u4f30\u5f53\u524d\u7684\u6587\u732e\u3002\u64b0\u5199\u5c0f\u7ec4\u4f7f\u7528\u8840\u7ba1\u548c\u4ecb\u5165\u795e\u7ecf\u5b66\u6307\u5357\u548c\u5b9e\u8df5\u6807\u51c6\u63a8\u8350\/\u8bc1\u636e\u7ea7\u522b\u7b97\u6cd5\u548c\u8840\u7ba1\u548c\u4ecb\u5165\u795e\u7ecf\u5b66\u6307\u5357\u548c\u5b9e\u8df5\u6807\u51c6\u6307\u5357\u683c\u5f0f\u5206\u914d\u5efa\u8bae\u3002\u6700\u7ec8\u7684\u6307\u5357\u5f97\u5230\u4e86\u64b0\u5199\u5c0f\u7ec4\u7684\u6240\u6709\u6210\u5458\u3001\u6307\u5357\u548c\u5b9e\u8df5\u6807\u51c6\u59d4\u5458\u4f1a\u4ee5\u53ca\u8840\u7ba1\u548c\u4ecb\u5165\u795e\u7ecf\u75c5\u5b66\u534f\u4f1a\u8463\u4e8b\u4f1a\u7684\u6279\u51c6\u3002<\/p>\n
\u7ed3\u679c \u6587\u732e\u7efc\u8ff0\u4ea7\u751f\u4e863\u4e2a\u9ad8\u8d28\u91cf\u7684\u968f\u673a\u8bd5\u9a8c\u548c\u51e0\u4e2a\u89c2\u5bdf\u6027\u7814\u7a76\uff0c\u8fd9\u4e9b\u7814\u7a76\u5df2\u88ab\u63d0\u53d6\u51fa\u6765\uff0c\u4ee5\u5f97\u51fa\u9644\u5448\u7684\u603b\u7ed3\u5efa\u8bae\u3002\u5927\u8840\u7ba1\u95ed\u585e\u7684\u60a3\u8005\u8868\u73b0\u4e3a6-24\u5c0f\u65f6\u7a97\u671f\uff0c\u4e34\u5e8a\u5f71\u50cf\u5b66\u4e0d\u5339\u914d\uff0c\u5982DAWN(\u5f25\u6563\u52a0\u6743\u6210\u50cf\u6216\u8ba1\u7b97\u673a\u65ad\u5c42\u6210\u50cf\u704c\u6ce8\u8bc4\u4f30\u4e0e\u4e34\u5e8a\u4e0d\u5339\u914d\u7684\u5524\u9192\u548c\u665a\u671f\u8868\u73b0\u4e2d\u98ce\u60a3\u8005\u63a5\u53d7Trevo\u795e\u7ecf\u5e72\u9884\uff09\u548cDEFUSE 3(\u7f3a\u8840\u6027\u8111\u5352\u4e2d\u5f71\u50cf\u5b66\u8bc4\u4f30\u540e\u7684\u8840\u7ba1\u5185\u6cbb\u7597)\u7814\u7a76\u6240\u5b9a\u4e49\uff0c\u5efa\u8bae\u8840\u7ba1\u5185\u6cbb\u7597\u3002\u5e73\u626bCT\u6210\u50cf\u53ef\u7528\u4e8e\u8bc4\u4f30\u6897\u6b7b\u9762\u79ef\uff0c\u4f5c\u4e3a\u60a3\u8005\u9009\u62e9\u7684\u552f\u4e00\u6210\u50cf\u65b9\u5f0f\uff0c\u7279\u522b\u662f\u5f53\u8ba1\u7b97\u673a\u65ad\u5c42\u6210\u50cf\u704c\u6ce8\u6216\u78c1\u5171\u632f\u6210\u50cf\u53d7\u5230\u9650\u5236\u6216\u5176\u8868\u73b0\u4f1a\u5bfc\u81f4\u6cbb\u7597\u5ef6\u8fdf\u65f6\u3002\u6b64\u5916\uff0c\u57fa\u4e8e\u73b0\u6709\u8bc1\u636e\u548c\u5171\u8bc6\u5206\u7ea7\uff0c\u6211\u4eec\u5bf9\u51e0\u4e2a\u4e34\u5e8a\u95ee\u9898\u8fdb\u884c\u4e86\u56de\u987e\u3002<\/p>\n
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\u65b9\u6cd5<\/p>\n
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\u5199\u4f5c\u5c0f\u7ec4<\/p>\n
2021\u5e748\u6708\uff0c\u4e00\u4e2a\u8de8\u5b66\u79d1\u7684\u56fd\u9645\u5199\u4f5c\u5c0f\u7ec4\u6210\u7acb\uff0c\u6210\u5458\u5305\u62ec\u6765\u81ea\u8840\u7ba1\u548c\u4ecb\u5165\u795e\u7ecf\u75c5\u5b66\u5b66\u4f1a(SVIN)\u3001\u7f8e\u56fd\u5352\u4e2d\u534f\u4f1a\u3001\u7f8e\u56fd\u795e\u7ecf\u75c5\u5b66\u5b66\u4f1a\u3001\u4e16\u754c\u5352\u4e2d\u7ec4\u7ec7\u548c\u6b27\u6d32\u5352\u4e2d\u7ec4\u7ec7\u7684\u4ee3\u8868\u3002\u8be5\u5c0f\u7ec4\u7531\u4e0b\u5217\u4eba\u5458\u7ec4\u6210:\u5185\u5bb9\u4e13\u5bb6(T.N.N. and A.C.C.\u64b0\u5199\u5c0f\u7ec4\u8054\u5408\u4e3b\u5e2d;R.G.N., G.W.A., T.G.V., S.O.M., M.G.L., S.N., J.E.S., S.A.S., J.P.T., and M.A.)\uff0c\u65b9\u6cd5\u4e13\u5bb6(A.C.C.\u548cA.D.)\u548c\u6307\u5bfc\u65b9\u9488\u548c\u5b9e\u8df5\u6807\u51c6\u59d4\u5458\u4f1a\u4e3b\u5e2d(O.O.Z)\u3002\u8868S1\u5217\u51fa\u4e86\u4f5c\u8005\u6240\u62ab\u9732\u7684\u4fe1\u606f\u3002\u521b\u5efa\u4e86\u4eba\u7fa4\u3001\u5e72\u9884\u63aa\u65bd\u3001\u6bd4\u8f83\u5bf9\u8c61\u3001\u7ed3\u679c\u3001\u65f6\u95f4\u548c\u80cc\u666f\u8868(\u88681)\u3002\u63a8\u8350\u7b49\u7ea7(COR)\u548c\u8bc1\u636e\u6c34\u5e73(LOE)\u6807\u51c6\u4f7f\u7528SVIN\u6307\u5357\u548c\u5b9e\u8df5\u6807\u51c6\u7b97\u6cd5(\u56fe)\u3002\u6240\u6709\u7684\u4f5c\u8005\u90fd\u4f7f\u7528\u4fee\u6b63\u7684\u5fb7\u5c14\u83f2\u5171\u8bc6\u5bf9\u6bcf\u4e2a\u5efa\u8bae\u8fdb\u884c\u6295\u7968\uff0c\u9664\u4e86\u4e0e\u4ed6\u4eec\u7684\u884c\u4e1a\u5173\u7cfb\u76f8\u5173\u7684\u5efa\u8bae(\u8865\u5145\u8868S1\uff0c\u88682)\u3002\u968f\u540e\u662f\u7814\u7a76\u6307\u5357\u8bc4\u4f30\u548c\u4e34\u5e8a\u5b9e\u8df5\u6307\u5357\u8bc4\u4f30\u62a5\u544a\u68c0\u67e5\u8868(\u8865\u5145\u8868S3)\u3002\u8be5\u6307\u5357\u5df2\u63d0\u4ea4SVIN\u6307\u5357\u548c\u5b9e\u8df5\u6807\u51c6\u59d4\u5458\u4f1a\u548c\u8463\u4e8b\u4f1a\u8fdb\u884c\u5ba1\u67e5\u548c\u6279\u51c6\u3002<\/p>\n
\u8bc1\u636e\u6458\u8981<\/p>\n
\u4ece2010\u5e741\u6708\u52302022\u5e743\u6708\uff0c\u901a\u8fc7PubMed\u641c\u7d22\u6587\u732e\uff0c\u4f7f\u7528\u7684\u5305\u542b\u4ee5\u4e0b\u5173\u952e\u8bcd\u7684\u641c\u7d22\u6761\u4ef6\uff1a\u6025\u6027\u7f3a\u8840\u6027\u4e2d\u98ce(AIS)\uff0c\u53d6\u6813\uff0c6- 24\u5c0f\u65f6\u6216\u665a\u7a97\u53d6\u6813\u3002\u5728\u6700\u521d\u7684\u641c\u7d22\u4e2d\uff0c\u5171\u6709358\u9879\u7814\u7a76\u88ab\u786e\u5b9a\uff0c\u5e76\u75312\u4f4d\u4f5c\u8005\u8fdb\u884c\u7b5b\u9009(T.N.N.\u53caA.C.C)\u3002\u7531\u4e8e\u4ee5\u4e0b\u539f\u56e0\uff0c\u7814\u7a76\u88ab\u6392\u9664\u5728\u5916\uff1a\u65e0\u665a\u671f\u7a97\u53e3\u6cbb\u7597\u3001\u5b9a\u6027\u56de\u987e\u3001\u6df7\u5408\u60a3\u8005\u7fa4\u4f53(\u65e9\u671f\u548c\u665a\u671f\u7a97\u53e3)\u3001\u75c5\u4f8b\u7814\u7a76\u6216<5\u4f8b\u60a3\u8005\u3001\u65e0\u6cd5\u83b7\u5f97\u5b8c\u6574\u6587\u672c\u3001\u8bc4\u8bba\u3001\u65b9\u6848\u3001\u4e8c\u6b21\u5206\u6790\u30016 – 24\u5c0f\u65f6\u5185\u672a\u6cbb\u7597\u7684\u60a3\u8005\u3001\u6307\u5357\u3001\u6df7\u5408\u4eba\u7fa4(\u53d6\u6813\u548c\u975e\u53d6\u6813\u60a3\u8005)\u3001\u4f53\u5185\/\u4f53\u5916\u65e0LVO(\u8865\u5145\u56feS1\uff0c\u8868S2)\u3002<\/p>\n
\u57286- 24\u5c0f\u65f6\u7684\u65f6\u95f4\u7a97\u5185\u9009\u62e9\u75c5\u4eba<\/p>\n
Mismatch\u6807\u51c6<\/p>\n
\u4e0e\u65e9\u671f\u65f6\u95f4\u7a97MT\u8bd5\u9a8c\u76f8\u6bd4\uff0cDAWN\u548cDEFUSE 3\u4f7f\u7528\u5148\u8fdb\u7684\u6210\u50cf\u7814\u7a76(\u8ba1\u7b97\u673a\u65ad\u5c42\u6210\u50cf\u704c\u6ce8[CTP]\u6216\u78c1\u5171\u632f\u6210\u50cf[MRI])\u6765\u8bc4\u4f30\u53ef\u62a2\u6551\u7684\u8111\u7ec4\u7ec7\u548c\u6897\u6b7b\u7ec4\u7ec7\u7684\u8303\u56f4\u3002\u4e0d\u5339\u914d\uff08Mismatch\uff09\uff0c\u5b9a\u4e49\u4e3a\u5b58\u5728\u5371\u9669\u7684\u5b58\u6d3b\u8111\u7ec4\u7ec7(\u534a\u6697\u533a)\u4f53\u79ef\u5927\u4e8e\u73b0\u6709\u6897\u6b7b\u8111\u7ec4\u7ec7\u4f53\u79ef\uff0c\u662fDAWN\u548cDEFUSE 3\u7684\u4e3b\u8981\u5165\u9009\u6807\u51c6(\u88683)\u3002\u5728DEFUSE 3\u7684\u5931\u5339\u914d\u5b9a\u4e49\u4e3a\u6897\u6b7b\u6838\u5fc3\u4f53\u79ef<70 mL\uff0c\u5931\u914d\u4f53\u79ef\u226515 mL\uff0c\u7f3a\u8840\u4f53\u79ef\u4e0e\u6897\u6b7b\u4f53\u79ef\u7684\u6bd4\u503c\u22651.8\u3002\u6b64\u5916\uff0cDAWN\u5e94\u7528\u4e86\u4e34\u5e8a\u6807\u51c6\u3001\u5e74\u9f84\u548c\u7f8e\u56fd\u56fd\u7acb\u536b\u751f\u7814\u7a76\u9662\u5352\u4e2d\u91cf\u8868(NIHSS)\u7684\u8bc4\u5206\u4e34\u754c\u503c\u4f5c\u4e3a\u5931\u914d\u6807\u51c6\u7684\u4e00\u90e8\u5206\u3002\u9274\u4e8e\u5176\u4f18\u8d8a\u6027\u7684\u8bc1\u636e\uff0cEVT\u88ab\u63a8\u8350\u7528\u4e8e\u7b26\u5408DAWN\u548cDEFUSE 3\u6807\u51c6(COR-1, LOE A)\u7684\u60a3\u8005\u3002<\/p>\n
\u9ad8\u7ea7\u6210\u50cf\u9009\u62e9<\/p>\n
CT\u704c\u6ce8<\/p>\n
CTP\u626b\u63cf\u662f\u4e00\u79cd\u7ecf\u8fc7\u9a8c\u8bc1\u7684\u5de5\u5177\uff0c\u53ef\u4ee5\u5bf9\u8840\u6d41\u5f02\u5e38\u8fdb\u884c\u6210\u50cf\uff0c\u5e76\u4f30\u8ba1\u7f3a\u8840\u6838\u5fc3\u548c\u534a\u6697\u5e26\u7684\u4f53\u79ef\u548c\u4f4d\u7f6e\u3002\u5b83\u662f\u53ef\u8bbf\u95ee\u7684\u548c\u9ad8\u6548\u7684\u4e14\u8f90\u5c04\u5242\u91cf\u6709\u9650\uff0c\u5e73\u5747\u91c7\u96c6\u65f6\u95f4\u5c0f\u4e8e90\u79d2\uff0c\u81ea\u52a8\u5316\u540e\u5904\u7406\u8f6f\u4ef6\u5141\u8bb8\u5feb\u901f\u548c\u65b9\u4fbf\u7684\u5373\u65f6\u8bbf\u95eeCTP\u7ed3\u679c\u3002<\/p>\n<\/p>\n
\u4e34\u5e8a\u4f7f\u7528CTP\u9700\u8981\u6280\u672f\u4e0a\u5145\u5206\u7684\u56fe\u50cf\u91c7\u96c6\u548c\u51c6\u786e\u7406\u89e3\u5176\u89e3\u91ca\u548c\u5c40\u9650\u6027\u3002\u5e94\u8be5\u4f7f\u7528\u7ecf\u8fc7\u9a8c\u8bc1\u7684\u6700\u4f73CTP\u53c2\u6570\u3001\u9608\u503c\u548c\u540e\u5904\u7406\u7b97\u6cd5\u3002\u4e0e\u5f25\u6563\u52a0\u6743\u6210\u50cf(DWI)\u4e0d\u540c\uff0cCTP\u7684\u7f3a\u8840\u6838\u5fc3\u5e76\u6ca1\u6709\u663e\u793a\u6b7b\u4ea1\u7ec4\u7ec7\uff0c\u4f46\u52fe\u753b\u51fa\u8840\u6d41\u975e\u5e38\u4f4e\u7684\u533a\u57df\uff0c\u6781\u6709\u53ef\u80fd\u9020\u6210\u4e0d\u53ef\u9006\u635f\u4f24\u3002\u76f8\u5bf9\u8111\u8840\u6d41\u51cf\u5c11\u786e\u5b9a\u7f3a\u8840\u6838\u5fc3\u7684\u6700\u4f73\u9608\u503c<\u6b63\u5e38\u768430%\u81f335%\uff0c\u800c\u6b8b\u9980\u529f\u80fd\u8fbe\u5230\u6700\u5927\u503c\u7684\u65f6\u95f4>6\u79d2\u5219\u6807\u5fd7\u7740\u7f3a\u8840\u534a\u6697\u5e26\u5728\u65e0\u518d\u704c\u6ce8\u65f6\u6709\u6897\u6b7b\u7684\u5371\u9669\u3002\u7531\u4e8eCTP\u662f\u57fa\u4e8e\u56fe\u50cf\u91c7\u96c6\u65f6\u523b\u7684\u8840\u6d41\u52a8\u529b\u5b66\u7684\u7ec4\u7ec7\u7684\u6982\u7387\u56fe\uff0c\u5f53\u4e0e\u6700\u7ec8\u7684\u6897\u6b7b\u4f53\u79ef\u76f8\u6bd4\uff0c\u8111\u4f4e\u704c\u6ce8\u7684\u5ef6\u957f\u6216\u6076\u5316\u53ef\u80fd\u4f1a\u5bfc\u81f4\u8fd9\u79cd\u9884\u6d4b\u7684\u611f\u77e5\u51c6\u786e\u6027\u7684\u53d8\u5316\u3002<\/p>\n
\u901a\u8fc7\u8fd9\u4e9b\u6280\u672f(CTP\u548cMRI)\u8bc6\u522b\u53ef\u80fd\u6709\u53ef\u62a2\u6551\u7ec4\u7ec7\u7684\u60a3\u8005\u7684\u80fd\u529b\uff0c\u5efa\u7acb\u4e86EVT\u5bf9LVO\u665a\u671f\u65f6\u95f4\u7a97\u7684\u4e34\u5e8a\u76ca\u5904\u3002\u6839\u636eDAWN\u548cDEFUSE 3\u8d44\u683c\u6807\u51c6\uff0c2019\u5e74\u7f8e\u56fd\u5fc3\u810f\u534f\u4f1a\/\u7f8e\u56fd\u5352\u4e2d\u534f\u4f1a\u6307\u5357\u63a8\u8350\u4f7f\u7528CTP\u4f5c\u4e3aEVT\u60a3\u8005\u9009\u62e9\u7684\u5f71\u50cf\u5b66\u6a21\u5f0f\u4e4b\u4e00(COR-1;LOE A)\u3002<\/p>\n
ASPECTS\u8868\u793a\u963f\u5c14\u4f2f\u5854\u4e2d\u98ce\u8ba1\u5212\u65e9\u671f\u8ba1\u7b97\u673a\u65ad\u5c42\u626b\u63cf\u8bc4\u5206\uff1bBP\uff0c\u8840\u538b\uff1bCOR\uff0c\u63a8\u8350\u7b49\u7ea7\uff1bCT\uff0c\u8ba1\u7b97\u673a\u65ad\u5c42\u6444\u5f71;DAWN\uff0c\u5f25\u6563\u52a0\u6743\u6210\u50cf\u6216\u8ba1\u7b97\u673a\u65ad\u5c42\u6210\u50cf\u704c\u6ce8\u8bc4\u4f30\u4e0e\u4e34\u5e8a\u4e0d\u5339\u914d\u7684\u5524\u9192\u548c\u665a\u671f\u8868\u73b0\u4e2d\u98ce\u60a3\u8005\u63a5\u53d7Trevo\u795e\u7ecf\u5e72\u9884\uff1bDEFUSE 3\uff0c\u7f3a\u8840\u6027\u8111\u5352\u4e2d\u5f71\u50cf\u5b66\u8bc4\u4f30\u540e\u7684\u8840\u7ba1\u5185\u6cbb\u7597\uff1bDWI\uff0c\u6269\u6563\u52a0\u6743\u6210\u50cf\uff1bEO-C\uff0c\u4e13\u5bb6\u610f\u89c1\u5171\u8bc6\uff1bEVT\uff0c\u8840\u7ba1\u5185\u6cbb\u7597\uff1bLD\uff0c\u6709\u9650\u6570\u636e\uff1bLOE\uff0c\u8bc1\u636e\u6c34\u5e73\uff1bLVO\uff0c\u5927\u8840\u7ba1\u95ed\u585e\uff1bMRI\uff0c\u78c1\u5171\u632f\u6210\u50cf\uff1bMT\uff0c\u673a\u68b0\u53d6\u6813\uff1bNCCT\uff0c\u65e0\u53cd\u5dee\u5934\u90e8\u8ba1\u7b97\u673a\u65ad\u5c42\u6444\u5f71\u672f\uff1bNIHSS\uff0c\u7f8e\u56fd\u56fd\u7acb\u536b\u751f\u7814\u7a76\u9662\u4e2d\u98ce\u91cf\u8868\uff1bNR\uff0c\u975e\u968f\u673a\uff1bR\uff0c\u968f\u673a\uff1b\u4ee5\u53caTICI\uff0c\u8111\u6897\u6b7b\u7684\u6eb6\u6813\u6cbb\u7597\u3002<\/p>\n
AURORA\uff08\u6700\u540e\u4e00\u6b21\u786e\u8bca\u540e6\u5c0f\u65f6\u4ee5\u4e0a\u53d6\u6813\u7684\u968f\u673a\u7814\u7a76\u6c47\u603b\u6570\u636e\u5206\u6790\uff09 \u5408\u4f5c\u7814\u7a76\u6c47\u96c6\u4e86\u6765\u81ea6\u4e2a\u4e34\u5e8a\u8bd5\u9a8c\u7684505\u540d\u60a3\u8005\u7684\u6570\u636e\uff0c\u5e76\u8fdb\u4e00\u6b65\u652f\u6301\u4e86\u53d6\u8840\u6813\u7684\u76ca\u5904\u4e0e90\u5929\u7684\u72ec\u7acb\u529f\u80fd\u76f8\u5173(\u6539\u826fRankin\u91cf\u8868[mRS]\u8bc4\u52060-2)\uff0c\u672a\u7ecf\u8c03\u6574\u7684\u5171\u540c\u4f18\u52bf\u6bd4(OR)\u4e3a2.42\u3002\u5728372\u540d\u4e34\u5e8a\u5931\u914d\u6216\u704c\u6ce8\u5931\u914d\u5f71\u50cf\u5b66\u8d44\u6599\u53ef\u7528\u7684\u60a3\u8005\u4e2d\uff0cCTP\u9776\u533a\u5931\u914d\u7684\u5b58\u5728\u662f\u6539\u5584\u529f\u80fd\u7ed3\u5c40\u7684\u9884\u6d4b\u56e0\u5b50(OR, 3.13;P =0.001)\u3002\u8fd9\u79cd\u6548\u5e94\u968f\u7740\u65f6\u95f4\u7684\u63a8\u79fb\u800c\u589e\u5f3a\uff0c\u572812 – 24\u5c0f\u65f6\u65f6\u6700\u5f3a(OR,5.01;P<0.001)\u3002\u76f8\u6bd4\u4e4b\u4e0b\uff0cCTP\u6ca1\u6709\u660e\u786e\u9776\u70b9\u9519\u914d\u7684\u60a3\u8005\u4eceEVT\u4e2d\u6ca1\u6709\u83b7\u5f97\u663e\u8457\u7684\u4e34\u5e8a\u76ca\u5904\u3002<\/p>\n<\/p>\n
\u78c1\u5171\u632f\u6210\u50cf<\/p>\n
\u867d\u7136\u57fa\u4e8eCT\u7684\u6210\u50cf\u4ecd\u7136\u662f\u8bc4\u4f30\u4f34\u6709LVO\u7684AIS\u60a3\u8005\u548c\u786e\u5b9a\u662f\u5426\u9002\u5408EVT\u7684\u6700\u53ef\u884c\u65b9\u6cd5\uff0c\u4f46\u4e00\u4e9b\u4e2d\u5fc3\u66f4\u559c\u6b22\u57fa\u4e8eMRI\u7684\u65b9\u6848\uff0c\u56e0\u4e3a\u5b83\u4eec\u5728DWI\u4e0a\u786e\u5b9a\u7f3a\u8840\u6838\u4f53\u79ef\u65b9\u9762\u5177\u6709\u4f18\u52bf\u3002\u7136\u800c\uff0c\u8ba1\u7b97\u673a\u65ad\u5c42\u626b\u63cf(CT)\u8840\u7ba1\u6210\u50cf\u6bd4\u78c1\u5171\u632f\u8840\u7ba1\u6210\u50cf\u66f4\u51c6\u786e\u5730\u8bc6\u522bLVO\uff0c\u56e0\u4e3a\u65f6\u95f4\u98de\u8dc3\u6cd5\uff08TOF\uff09\u78c1\u5171\u632f\u8840\u7ba1\u6210\u50cf\u66f4\u6709\u53ef\u80fd\u5c06\u4e25\u91cd\u72ed\u7a84\u663e\u793a\u4e3a\u95ed\u585e\u3002\u6b64\u5916\uff0cDWI\u53cd\u6620\u7f3a\u8840\u6838\u5fc3\u4e0d\u53ef\u9006\u635f\u4f24\u7684\u5047\u8bf4\u4ecd\u5b58\u5728\u6fc0\u70c8\u7684\u4e89\u8bba\u3002\u4f8b\u5982\uff0c\u591a\u8fbe25%\u7684AIS\u60a3\u8005\u5728\u5352\u4e2d\u65e9\u671f\u53ef\u4ee5\u770b\u5230DWI\u7684\u53ef\u9006\u6027\uff0c\u4f46\u5728\u5352\u4e2d\u53d1\u4f5c\u540e24\u5c0f\u65f6\uff0cDWI\u4ecd\u4f18\u4e8ect\u6897\u6b7b\u6838\u5fc3\u6d4b\u91cf\u3002<\/p>\n<\/p>\n
\u5728DEFUSE 3\u548cDAWN\u8bd5\u9a8c\u4e2d\uff0c\u90fd\u5141\u8bb8\u5bf9\u7f3a\u8840\u6838\u4f53\u79ef\u8fdb\u884cMRI\u8bc4\u4ef7\uff0c\u5e76\u4e14\u5728DEFUSE 3\u4e2d\uff0c\u5141\u8bb8\u7528\u52a8\u6001\u654f\u611f\u6027\u5bf9\u6bd4\u5e8f\u5217\u8fdb\u884cMRI\u704c\u6ce8\u8bc4\u4ef7\u4f4e\u704c\u6ce8\u4f53\u79ef(\u7f3a\u8840\u534a\u6697\u5e26+\u7f3a\u8840\u6838)\u3002\u5728DEFUSE 3\u548cDAWN\u4e2d\uff0c\u5206\u522b\u670926.9%(49\/182)\u548c36.4%(75\/206)\u7684\u53c2\u4e0e\u8005\u63a5\u53d7MRI\u8bc4\u4f30\u3002\u5c3d\u7ba1DAWN\u5728\u521d\u6b65\u5206\u6790\u4e2d\u6ca1\u6709\u62a5\u9053\u5f71\u50cf\u5b66\u65b9\u5f0f\u4e0eEVT\u6cbb\u7597\u4e4b\u95f4\u7684\u76f8\u4e92\u4f5c\u7528\uff0c\u4f46\u5728DEFUSE 3\u4e2d\uff0c\u8fd9\u79cd\u76f8\u4e92\u4f5c\u7528\u7f3a\u4e4f\u663e\u8457\u6027(P=0.41)\uff0c\u63d0\u793aCTP\u6216MRI\u5165\u7ec4\u7684\u60a3\u8005\u5e76\u6ca1\u6709\u6539\u53d8EVT\u7684\u7597\u6548\u3002\u56e0\u6b64\uff0c2019\u5e74\u7f8e\u56fd\u5fc3\u810f\u534f\u4f1a\u6307\u5357\u6307\u51fa\uff0c\u5728\u786e\u5b9a\u665a\u671f\u7a97\u53e3\u671fEVT\u7684\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c\u4e00\u81f4\u6027\u5408\u683c\u65f6\uff0cMRI\u76f8\u5f53\u4e8e\u57fa\u4e8eCTP\u7684\u8bc4\u4f30\u3002\u7136\u800c\uff0c\u8fd9\u4e9b\u8bd5\u9a8c\u5e76\u4e0d\u80fd\u89e3\u51b3\u8fd9\u4e2a\u6bd4\u8f83\u95ee\u9898\u3002<\/p>\n
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\u5934\u90e8CT\u5e73\u626b\u9009\u62e9<\/p>\n
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\u8fc4\u4eca\u4e3a\u6b62\uff0c\u5173\u4e8e\u665a\u65f6\u95f4\u7a97AIS LVO\u60a3\u8005\u9009\u62e9NCCT\u4e0eCTP\u7684\u6700\u5927\u7814\u7a76\u662fCLEAR\u5408\u4f5c\u7684\u4e00\u9879\u591a\u4e2d\u5fc3\u961f\u5217\u7814\u7a76\uff0c\u8be5\u7814\u7a76\u5bf9\u8fde\u7eed\u63a5\u53d7EVT\u6cbb\u7597\u7684\u60a3\u8005\u8fdb\u884c\u4e86\u7814\u7a76\u3002\u8fd9\u9879\u7814\u7a76\u5305\u62ec\u6765\u81ea\u6b27\u6d32\u548c\u5317\u7f8e15\u4e2a\u5730\u70b9\u76841604\u540d\u60a3\u8005\u3002\u5176\u4e2d\uff0c534\u4f8b\u8fdb\u884cEVT\u9009\u62e9\u5e76\u8fdb\u884cNCCT, 752\u4f8b\u8fdb\u884cCTP, 318\u4f8b\u8fdb\u884cMRI\u3002\u91c7\u7528\u4e0d\u540c\u5f71\u50cf\u5b66\u9009\u62e9\u65b9\u5f0f\u6cbb\u7597\u7684\u60a3\u8005(NCCT\u7ec4\u4e3a8.1%\uff0cCTP\u7ec4\u4e3a5.8%\uff0cMRI\u7ec4\u4e3a4.7%)\uff0c\u5373\u4f7f\u5728\u6210\u529f\u518d\u704c\u6ce8\u7684\u60a3\u8005\u4e2d\uff0c\u75c7\u72b6\u6027\u9885\u5185\u51fa\u8840\u7684\u53d1\u751f\u7387\u4e5f\u6ca1\u6709\u663e\u8457\u5dee\u5f02\u3002NCCT\u548cCTP\u4e4b\u95f490\u5929\u529f\u80fd\u72ec\u7acb\u6027\u7684\u6bd4\u7387\u5177\u6709\u53ef\u6bd4\u6027;NCCT\u548cCTP\u7684\u672a\u8c03\u6574\u503c\u5206\u522b\u4e3a41%\u548c44%\uff0c\u4e0eDAWN\u548cDEFUSE 3\u8840\u7ba1\u5185\u652f\u76f8\u6bd4\u8f83(\u5206\u522b\u4e3a49%\u548c45%)\u3002\u5728\u591a\u53d8\u91cf\u5206\u6790\u4e2d\uff0cNCCT\u7ec4\u548cCTP\u7ec4\u572890\u5929\u7684\u969c\u788d\u7ed3\u679c\u65b9\u9762\u6ca1\u6709\u5dee\u5f02(\u8c03\u6574\u540e\u7684OR, 0.90 [95% CI, 0.7-1.2])\u3002\u503c\u5f97\u6ce8\u610f\u7684\u662f\uff0cNCCT\u7ec4\u4ece\u5165\u9662\u5230\u52a8\u8109\u7a7f\u523a\u7684\u65f6\u95f4\u66f4\u5feb(76\u5206\u949f\u5bf993\u5206\u949f\uff0cNCCT\u5bf9CTP)\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"
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