两种不同血管再通方法在急性脑动脉闭塞中的应用比较  

Comparison of Two Different Vascular Recanalization Methods in Acute Cerebral Artery Occlusion

作　　者：褚桂芬 张弘[1] 李高华[1] 柏琦 CHU Guifen;ZHANG Hong;LI Gaohua(General Hospital of Fushun Mining Bureau,Liaoning Fushun 113008,China)

机构地区：[1]抚顺矿务局总医院神经内科,辽宁抚顺113008

出　　处：《河北医学》2018年第11期1899-1903,共5页Hebei Medicine

基　　金：辽宁省自然科学基金项目(编号:201502004)

摘　　要：目的:比较两种不同血管再通方法(机械取栓与动脉溶栓)在急性脑动脉闭塞中的应用。方法:对68例行机械取栓患者和50例行动脉溶栓患者的临床资料行回顾性分析,比较两组患者术前及术后NIHSS评分变化、穿刺至获得再通时间、血管再通率、颅内出血发生率、死亡率及术后3个月mRs评分。结果:机械取栓组患者穿刺至获得再通时间显著低于动脉溶栓组(P<0.05);机械取栓组患者血管再通率显著高于动脉溶栓组(P<0.05);机械取栓组患者颅内出血总发生率显著低于动脉溶栓组(P<0.05);比较两组术后3个月mRS评分及NIHSS评分提示差异无统计学意义(P>0.05);机械取栓组患者3个月时良好预后率显著优于动脉溶栓组(P<0.05)。结论:相比动脉溶栓治疗,机械取栓治疗对急性脑动脉闭塞患者而言具有更宽的时间窗,更高的再通率,更低的出血率,有利于改善患者预后情况,临床上宜提倡。Objective： To compare the application of two different ways of vascular recanalization （mechanical thrombectomy and arterial thrombolysis） in acute cerebral artery occlusion. Methods： The clinicaldata of 68 patients with mechanical thrombectomy in our hospital and 50 cases of arterial thrombolytic patientswere retrospectively analyzed. The changes of NIHSS score before and after operation, puncture to repassagetime, blood vessel repassage rate, incidence of intracranial hemorrhage, mortality and 3 months mRs after operation were compared between the two groups. Results： The time of the puncture and repassage of the patientsin the mechanical thrombectomy group was significantly lower than that of the arterial thrombolytic group （P〈0.05）, the repassage rate of the patients in the mechanical thrombectomy group was significantly higher thanthat of the arterial thrombolysis group （P〈0.05）. The total incidence rate of intracranial hemorrhage were significantly lower than that in the arterial thrombolytic group （P〈0.05）, and there was no significant differencebetween the two groups after 3 months＇ mRS score and the NIHSS score （P〉0.05）, the good prognosis rate ofthe patients in the mechanical thrombectomy group was significantly better than that in the arterial thrombolysisgroup （P〈0.05） at 3 months. Conclusion： Compared with the thrombolytic therapy, the treatment of thrombolytic therapy for the patients with acute cerebral artery occlusion has a wider time window, with a higher repassage rate, lower bleeding rate, which is beneficial to improve the prognosis of the patients, and should beadvocated in clinical.

关 键 词：急性脑动脉闭塞 机械取栓 动脉溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]