血管内支架介入成形术对老年缺血性脑卒中患者的神经功能及预后的影响  

The effect of endovascular stent-assisted angioplasty on neurological function and prognosis in elderly patients with ischemic stroke

作　　者：黄欣 黄婷[1] 李娜[1] 刘欢[2] 张玲[1] HUANG Xin;HUANG Ting;LI Na;LIU Huan;ZHANG Ling(Department of Neurology,Wuhan Central Hospital,Wuhan 430000,China;不详)

机构地区：[1]武汉市中心医院神经内科,武汉430000 [2]武汉市中心医院急诊科,武汉430000

出　　处：《空军医学杂志》2019年第6期499-502,共4页Medical Journal of Air Force

摘　　要：目的探究血管内支架介入成形术对老年缺血性脑卒中患者神经功能及预后的影响,为患者的治疗提供临床指导。方法选择2016年7月-2018年3月在武汉市中心医院住院治疗的167例老年缺血性脑卒中患者作为研究对象。按照入院ID末尾数字的奇偶性进行分组,将入院ID末尾数字为奇数的患者作为观察组(86例),偶数作为对照组(81例)。对照组采取静脉溶栓的方式进行治疗,观察组采取血管内支架介入成形术进行治疗。术后7 d对比2组脑梗死面积,并于术后1、7、14 d对2组患者的神经功能恢复情况及血管再通率进行比较,术后1、2、3个月后对2组预后恢复状况、病死率和不良反应/并发症总发生率进行比较分析。结果观察组在术后7 d的脑梗死面积明显小于对照组,差异有统计学意义(P<0.05)。观察组术后1、7 d和14 d的卒中量表(NIHSS)评分均明显低于对照组,差异有统计学意义(P<0.05)。观察组术后1、7、14 d以及随访结束后的血管再通率均明显高于对照组(P<0.05)。观察组术后1、2、3个月以及随访结束后的格拉斯哥预后量表(GOS)评分均显著高于对照组(P<0.05)。观察组病死率和不良反应/并发症总发生率均明显低于对照组,差异比较有统计学意义(P<0.05)。结论血管内支架介入成形术在治疗老年缺血性脑卒中上能够有效疏通其颅脑内外血管,可显著减少其梗死面积和神经功能缺损程度,有利于患者的预后恢复。Objective To research the effect of endovascular stent-assisted angioplasty on neurological function and prognosis in elderly patients with ischemic stroke. Methods 167 elderly patients with ischemic stroke hospitalized in our hospital from July 2016 to March 2018 were selected as the research objects. All patients were grouped according to the parity of the number at the end of admission ID. The patients with odd number at the end of admission ID were taken as observation group(86 cases)and even number as control group(81 cases). The patients in the observation group were treated by endovascular stent interventional angioplasty, while those in the control group were treated by intravenous thrombolysis. The cerebral infarction area was compared between the two groups on the 7 th day after operation, and on the 1 st, 7 th and 14 th day after operation. The recovery of nerve function and vascular recanalization rate were compared between the two groups. The prognosis of the two groups in one month, two months and three months after operation, mortality and the total incidence of adverse reactions/complications were compared and analyzed. Results The area of cerebral infarction in the observation group was significantly smaller than that in the control group one week after operation(P<0.05). The NIHSS scores of the observation group were significantly lower than those of the control group on the 1, 7 th and 14 th day after operation(P<0.05). The blood vessel recanalization rates of the observation group were significantly higher than those of the control group on the 1, 7, 14 th day after operation and after follow-up(P<0.05). The GOS scores of the observation group were significantly higher than those of the control group at 1, 2, 3 months after operation and after follow-up(P<0.05). The mortality and the total incidence of adverse reactions/complications in the observation group were significantly lower than those in the control group, and the difference was statistically significant(P<0.05). Conclusion Endovascul

关 键 词：血管内支架介入成形术 静脉溶栓治疗 老年缺血性脑卒中 神经功能 

分 类 号：R743[医药卫生—神经病学与精神病学]