Objective To investigate the significance of one-stop CT scan in guiding the conservative treatment of internal ca-rotid artery dissection-induced acute ischemic stroke. Methods A total of 16 cases of patients who were diagnosed of internal carotid artery dissection-induced acute ischemic stroke with good collateral circulation and normal cerebral perfusion by one-stop CT scan from March 2014 to March 2017, and a total of 12 patients who were diagnosed of internal carotid artery dissection-induced acute ischemic stroke with poor collateral circulation and cerebral perfusion by one-stop unenhanced CT scan in the emergency department in our hospi-tal and refused to undergo interventional surgery over the same period were included in the study, and they were treated with intrave-nous thrombolysis or anticoagulant therapy. The change of NIHSS scores between admission and discharge, mRS score at the third month, vascular recanalization at the sixth month and the incidence rates and mortality rates of complications were assessed. Results The NIHSS scores of two groups changed between admission and discharge. The study group was significantly better than the control group in the change of NIHSS scores (P<0.05). The clinical prognosis of the study group was significantly better than that of the control group after 3 months (P<0.05). The recanalization rate of the study group was significantly higher than that of the control group (P<0.05). There were no significant differences between the two groups in the incidence rates of symptomatic intracranial hemor-rhage, high perfusion encephalopathy and other complications (P>0.05). The mortality rate of patients in the study group were signifi-cantly lower than that in the control group (P<0.05). Conclusion Assessing collateral circulation and cerebral perfusion of patients with ICAD induced ischemic stroke through one-stop CT scan and treating patients with open collateral circulation and normal cerebral perfusion with early thrombolytic or anticoagulant therapy can improve recanalization rate and clinical prognosis, and reduce complica-tions and mortality rate, so as to improve life quality of patients.%目的 探讨一站式CT扫描对颈内动脉夹层(ICAD)致急性缺血性卒中内科保守治疗的指导意义.方法 选择解放军第180医院2014年3月至2017年3月行一站式CT扫描检查确诊的ICAD致急性缺血性卒中患者临床资料,其中侧支循环好、脑组织灌注好的患者16例(研究组),侧支循环差、脑组织灌注差且拒绝介入手术开通的患者21例(对照组),均进行静脉溶栓或抗凝治疗,评估入出院NIHSS评分改善情况、3个月后改良Rankin评分量表(mRS)评分、半年时血管再通情况及并发症发生率、死亡率等.结果 2组入出院时NIHSS评分变化,研究组明显优于对照组(P<0.05).2组3个月后临床预后对比,研究组明显优于对照组(P<0.05).研究组血管再通率明显高于对照组(P<0.05).2组患者症状性颅内出血、高灌注脑病等并发症的发生率比较差异无统计学意义(P>0.05).研究组患者病死率明显低于对照组(P<0.05).结论 通过一站式CT扫描评估ICAD致缺血性卒中患者的侧支循环及脑组织灌注情况,于对于侧支循环开放、脑组织灌注好的患者及早行溶栓或抗凝治疗,提高闭塞血管再通率,有助于改善临床预后,降低并发症发生及死亡率,提高患者生存质量.
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