单纯静脉溶栓与静脉溶栓联合血管内介入治疗对急性缺血性脑血管病的临床疗效比较  

Effect of intravenous thrombolysis and its combination with intravenous intervention on acute ischemic cerebrovascular diseases

作　　者：曹光宇 罗勇 Cao Guangyu;Luo Yong(Department of Neurology,Third Affiliated Hospital of Zunyi Medical University,Zunyi 563003,Guizhou Province,China)

机构地区：[1]遵义医科大学第三附属医院,遵义市第一人民医院神经内科,563003

出　　处：《中华老年心脑血管病杂志》2020年第4期402-405,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的比较单纯静脉溶栓与静脉溶栓联合血管内介入治疗对急性缺血性脑血管病的临床疗效。方法纳入我院收治的老年急性缺血性脑血管病患者180例为研究对象。将患者随机分为联合组(90例)和药物组(90例),分别给予静脉溶栓联合血管内介入治疗和单纯静脉溶栓治疗。分析比较2组患者血管再通率,病变血管收缩期峰流速值和美国国立卫生研究院卒中量表(NIHSS)评分及不良血管事件的发生率。结果联合组血管再通成功率显著高于药物组(67.8%vs 47.8%),差异有统计学意义(P<0.05)。与治疗前比较,联合组治疗后各血管的收缩期峰流速均显著下降(P<0.05);联合组治疗后各血管的收缩期峰流速明显低于药物组,差异有统计学意义(P<0.05)。与治疗前比较,治疗后2组6 h和12 h NIHSS评分显著改善,联合组治疗后各时间点NIHSS评分均明显低于药物组,差异有统计学意义(P<0.05)。治疗后12个月,联合组不良血管事件发生率明显低于药物组(3.3%vs 16.7%),差异有统计学意义(P<0.05)。结论静脉溶栓联合血管内介入治疗急性缺血性脑血管病的临床疗效明显优于单纯静脉溶栓治疗,血管再通率高,不良血管事件发生率低,值得临床推广应用。Objective To compare the therapeutic effect of intravenous thrombolysis and intravenous thrombolysis combined with intravascular intervention on acute ischemic cerebrovascular disease.Methods One hundred and eighty elderly acute ischemic cerebrovascular disease patients admitted to our hospital from October 2015 to September 2018 were randomly divided into intravenous thrombolysis combined with intravascular intervention group(n=90) and intravenous thrombolysis group(n=90).The rate of recanalization,peak flow velocity of diseased systolic blood vessels,NIHSS score and incidence of adverse vascular events were compared between the two groups and analyzed.Results The rate of recanalization was significantly higher in intravenous thrombolysis combined with intravascular intervention group than in intravenous thrombolysis group(67.8% vs 47.8%,P<0.05).The peak flow velocity of diseased systolic blood vessels was significantly slower in intravenous thrombolysis combined with intravascular intervention group after treatment than before treatment(P<0.05) and in intravenous thrombolysis combined with intravascular intervention group than in intravenous thrombolysis group after treatment(P<0.05).The NIHSS score was significantly higher in two groups at 6 and 12 h after treatment than before treatment and was significantly lower in intravenous thrombolysis combined with intravascular intervention group than in intravenous thrombolysis group at 6 and 12 h after treatment(P<0.05).The incidence of adverse vascular events was significantly lower in intravenous thrombolysis combined with intravascular intervention group than in intravenous thrombolysis group(3.3% vs 16.7%,P<0.05).Conclusion The therapeutic effect of intravenous thrombolysis combined with intravascular intervention is significantly better than that of intravenous thrombolysis on acute ischemic cerebrovascular disease with a high recanalization rate and a low incidence of adverse vascular events.Intravenous thrombolysis combined with intravascular intervention is

关 键 词：脑血管障碍 血栓溶解疗法 机械溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]