Stroke, tseem hu ua mob stroke hlwb, yog tshwm sim los ntawm tam sim ntawd rupture thiab los ntshav ntawm cov hlab ntsha nyob rau hauv lub hlwb los yog cerebral ischemia thiab tsis muaj oxygen vim cov hlab ntsha txhaws. Clinically, nws muab faib ua ob pawg: hemorrhagic thiab ischemic. Ntawm lawv, mob stroke ischemic yog tus cwj pwm los ntawm kev mob siab, kev tuag siab thiab kev tsis taus siab.
Tam sim no, txoj kev kho mob zoo tshaj plaws rau mob stroke ischemic ischemic recanalization ntawm cov hlab ntsha occluded. Recanalization kev kho mob suav nrog cov tshuaj yooj yim intravenous thrombolysis thiab endovascular interventional phais.
Cov neeg mob stroke tuaj yeem tau txais txiaj ntsig los ntawm cov hlab ntsha thrombolysis nyob rau hauv 4.5-6 teev ntawm lub sijhawm hyperacute ntawm stroke. Txawm li cas los xij, vim muaj ntau yam, txawm tias nyob hauv cov tebchaws uas muaj kev kho mob siab heev, tsawg dua 3% mus rau 8.5% ntawm cov neeg mob tuaj yeem tau txais kev kho mob thrombolytic. Kwv yees li 33% ntawm cov neeg mob tuaj yeem ua tiav kev kho mob tom qab tau txais cov hlab ntsha thrombolysis, tab sis nws tsis tuaj yeem qhib qhov occlusion ntawm cov hlab ntsha loj.
Intravascular recanalization therapy yog qhib cov hlab ntsha hauv cov hlab ntsha los ntawm kev cuam tshuam kev phais. Nws yog txoj kev kho mob ncaj ncees tshaj plaws thiab ua tau zoo los txhim kho cov ntshav mus rau lub hlwb.
Txoj kev siv feem ntau thiab tseem ceeb hauv kev kho mob endovascular recanalization yog mechanical thrombectomy, uas kuj suav nrog kev ncaj qha zais pa angioplasty thiab stent angioplasty rau hauv situ stenosis ntawm cerebral hlab ntsha.
Mechanical thrombectomy siv cov catheter nruab nrab, microguidewires, microcatheters, aspiration catheters, thrombectomy stent retriever thiab lwm yam cuab yeej, thiab siv ntau yam kev phais kom ncaj qha tshem tawm thrombus los ntawm cov hlab ntsha, kom cov hlab ntsha uas thaiv tau sai sai rov qhib. Txoj kev phais yuav yog siv lub thrombectomy stent retrieval los tuav lub thrombus thiab rub tawm ntawm cov hlab ntsha, los yog siv ib tug aspiration catheter ncaj qha aspirate lub thrombus thiab ces rub tawm.
Lub sijhawm kho lub qhov rais ntawm cov neeg kho tshuab thrombectomy tuaj yeem txuas ntxiv mus rau 16-24 teev tom qab pib ntawm tus kab mob raws li tus neeg mob lub paj hlwb mob thiab cerebrovascular collateral them nyiaj raws li txoj cai, thiab tus nqi recanalization yog siab. Hauv cov chaw kho mob neurointerventional feem ntau, Tus nqi rov ua dua ntawm cov tshuab thrombectomy rau cov neeg mob uas muaj cov hlab ntsha loj tuaj yeem ncav cuag ntau dua 80 txog 90%.