机构地区:[1]石家庄市第一医院(中心院区)神经内科,石家庄050011
出 处:《神经损伤与功能重建》2018年第9期433-436,共4页Neural Injury and Functional Reconstruction
基 金:2015年石家庄市科学技术研究与发展指导计划项目(15141293)
摘 要:目的:探讨不同血管再通方法对不同病因急性缺血性脑血管病患者的疗效。方法:80例急性缺血性脑卒中患者,根据治疗方法分为静脉溶栓组30例、机械取栓组24例及联合治疗组26例。根据TOAST分型标准将各组分为大动脉粥样硬化性卒中型(A型)、心源性栓塞型(B型)和其他病因型(C型)。评估患者治疗后血管再通情况和出血转化情况。治疗前和治疗后3 d行美国国立卫生研究院卒中量表(NIHSS)评分,治疗前及治疗后90 d评估日常生活能力Barthel指数(BI评分)、改良Rankin评分(mRS)。结果:治疗后,与静脉溶栓组、机械取栓组比较,联合治疗组的NIHSS评分更低(P<0.05),BI评分、mRS≤2分比例、血管再通比例更高(P<0.05),出血转化比例也更高(P<0.05)。机械取栓组中,治疗后,与A型、C型比较,B型NIHSS评分更低(P<0.05),BI评分、m RS≤2分比例、血管再通比例更高(P<0.05)。房颤相关性栓塞患者中,治疗后,与静脉溶栓组比较,机械取栓组和联合治疗组NIHSS评分均更低(P<0.05),BI评分、mRS≤2分比例、血管再通比例均更高(P<0.05);联合治疗组出血转化比例高于机械取栓组(P<0.05)。结论:急性缺血性脑血管病超急性期血管再通治疗中,静脉溶栓对动脉粥样硬化性卒中型疗效最佳。而在房颤相关性脑栓塞患者中,机械取栓可能为最佳选择。联合应用疗效好于单独治疗,但出血转化比例明显升高。Objective: To observe the effects of different methods of vascular recanalization on patients with different causes of acute ischemic cerebrovascular disease. Methods: Eighty patients with acute ischemic stroke were divided according to treatment method into intravenous thrombolysis group (n=30), mechanical thrombectomy group (n=24), and combined treatment group (n=26). According to the TOAST classification criteria, each group was further divided into three groups: large atherosclerotic stroke type (type A), cardiogenic embolism type (type B), and other etiological type (type C). Patients were evaluated for status of blood vessel recanalization and bleeding after treatment. Prior to and 3 days after treatment, patients were evaluated with the National Institute of Health Stroke Scale (NIHSS). Patients were additionally evaluated prior to and 90 days after treatment with the Barthel Index (BI) and modified Rankin Scale (mRS). Results: After treatment, compared with the intravenous thrombolysis group and the mechanical thrombectomy group, NIHSS score of the combined treatment group was lower (P〈0.05) and BI, mRS ratio, and vascular recanalization rate were higher (P〈 0.05); hemorrhagic transformation rate of the combined treatment group was also higher (P〈0.05). In the mechanical thrombectomy group, after treatment and compared with types A and C, type B showed lower NIHSS score (P〈0.05) and higher BI, mRS ratio, and vascular recanalization rate (P〈0.05). In patients with fibrillation associated with embolization, after treatment and compared with the intravenous thrombolysis group, NIHSS score of the mechanical thrombectomy group and combined treatment group was lower (P〈0.05) and BI, mRSratio, and vascular recanalization rate were higher (P〈0.05). Hemorrhagic transformation rate in the combined treatment group was significantly higher than that in the mechanical thrombectomy group (P〈0.05). Conclusion: In vascular recan
分 类 号:R741[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]
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