静脉溶栓桥接动脉取栓治疗急性脑梗死临床疗效分析  

Analysis of the clinical effect of thrombolysis and arterial thrombectomy in the treatment of acute cerebral infarction

作　　者：张立军 赵洁[2] 郝新斌 Zhang Lijun;Zhao Jie;Hao Xinbin(Department of Neurology,Liaoyang City Center Hospital,Liaoning Province,Liao yang 111000,China)

机构地区：[1]辽宁省辽阳市中心医院神经内科,111000 [2]大连大学附属中山医院神经内科,116000

出　　处：《疑难病杂志》2020年第1期17-20,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：辽宁省博士科研启动基金指导计划项目(20170520003)~~

摘　　要：目的观察静脉溶栓桥接动脉取栓治疗急性脑梗死的临床疗效。方法纳入2017年3月-2019年3月辽宁省辽阳市中心医院神经内科收治的急性脑梗死患者80例,依照治疗方式的不同,分为对照组34例和观察组46例。对照组给予静脉溶栓治疗,观察组给予静脉溶栓桥接动脉取栓治疗。于治疗24 h后评价临床疗效;比较2组患者入院时及治疗后24 h、3 d的NHISS评分,阻塞血管再通率、残余狭窄率≤30%例数、住院期间颅内出血发生例数及治疗后,3个月病死率。结果治疗后,观察组总有效率、阻塞血管再通率分别为84.78%、86.96%,高于对照组的61.76%、67.65%,组间比较差异有统计学意义(χ~2/P=5.524/0.019、4.356/0.037)。与入院时比较,2组治疗后24 h、3 d的NIHSS评分均依次降低(F=16.913、5.538,P均<0.05);观察组治疗后3 d的NIHSS评分显著低于对照组(t/P=3.321/0.001)。观察组残余狭窄率≤30%患者占比为52.17%,显著高于对照组的14.71%(χ~2/P=11.876/0.001);2组在颅内出血率及治疗后3个月病死率方面差异无统计学意义(P均>0.05)。结论静脉溶栓桥接动脉取栓治疗急性脑梗死患者可提高临床疗效,且安全性较高。Objective To observe the clinical effect of intravenous thrombolysis and arterial thrombectomy in the treatment of acute cerebral infarction.Methods From March 2017 to March 2019,80 patients with acute cerebral infarction were included in the Department of Neurology,Liaoyang Central Hospital,Liaoning Province.According to the different treatment,it was divided into control group(34 cases) and observation group(46 cases).The control group was given intravenous thrombolysis,and the observation group was given intravenous thrombolysis bridging artery thrombectomy.After 24 hours of treatment,the clinical effect was evaluated;the NHISS scores of the two groups were compared at the time of admission and24 hours and 3 days after treatment,the number of cases with obstructed blood vessels recanalization rate,residual stenosis rate≤30%,the number of cases with intracranial hemorrhage during hospitalization and the mortality rate of 3 months after treatment.Results After treatment,the total effective rate and the recanalization rate of the obstructed vessels in the observation group were 84.78% and 86.96%,which were higher than the control group’s 61.76% and 67.65%,(χ~2/P=5.524/0.019,4.356/0.037).Compared with the time of admission,the NIHSS scores of the two groups decreased sequentially at 24 h and 3 d after treatment(F=16.913,5.538,P <0.05);the NIHSS scores of the observation group at 3 d after treatment were significantly lower than those of the control group(t/P=3.321/0.001).The proportion of patients with residual stenosis≤30% in the observation group accounted for 52.17%,which was significantly higher than 14.71% in the control group(χ~2/P=11.876/0.001).There was no significant difference in intracranial hemorrhage rate and mortality at 3 months after treatment between the two groups(both P>0.05).Conclusion Intravenous thrombolysis and arterial thrombectomy can improve the clinical efficacy and safety of patients with acute cerebral infarction.

关 键 词：脑梗死 急性 静脉溶栓 动脉取栓 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]