颈动脉溶栓桥接血管内技术治疗急性脑梗死的疗效分析  

Therapeutic effect of carotid thrombolysis and bridging in the treatment of acute cerebral infarction

作　　者：左书浩[1] 宋春旺[1] ZUO Shuhao;SONG Chunwang(Department of Neurosurgery,the First Hospital of Shijiazhuang,Shijiazhuang,050000,China)

机构地区：[1]石家庄市第一医院神经外科,石家庄050000

出　　处：《临床急诊杂志》2020年第8期615-618,共4页Journal of Clinical Emergency

基　　金：河北省石家庄卫生和计划生育委员会计划(No:171792083)。

摘　　要：目的:分析颈动脉溶栓桥接血管内技术在急性脑梗死中的治疗效果。方法:对我院2015-11—2017-12期间进行颈动脉溶栓桥接血管内技术治疗的143例急性脑梗死患者临床资料进行回顾性分析,分析治疗前后NIHSS评分变化、手术一般情况、临床疗效、并发症及预后情况。结果:治疗后2 h、1 d、7 d NIHSS评分较治疗前有显著降低,差异有统计学意义(P<0.05),且随着时间的延长不断降低;就诊到颈动脉穿刺溶栓所用时间平均为(3.14±0.58)h,颈动脉穿刺注药平均时长(98.26±15.23)min,血管内治疗平均时长(85.17±15.16)min;神经功能缺损评分评价临床疗效显示:术后1个月,治愈75例,有效41例,无效27例,恶化0例,总有效率为81.12%;mRS量表评价预后显示:术后3个月,143例患者中97例mRS评分≤2分,46例mRS评分>2分,有效率为67.83%;Gonner评分评价血管再通情况显示,0级0例,1级0例,2级42例,3级101例,血管再通率为100.00%。结论:颈动脉溶栓桥接血管内技术确实兼具溶栓治疗简单便捷以及血管内技术成功率高、预后好的优点,值得进一步探索。Objective:To analyze the therapeutic effect of carotid artery thrombolysis and bridging in acute cerebral infarction.Method:The clinical data of 143 patients with acute cerebral infarction,who were treated by carotid thrombolysis and bridging in our hospital from November 2015 to December 2017,were analyzed retrospectively.The changes of NIHSS score,general condition after operation,clinical effect,complications and prognosis before and after treatment were analyzed.Result:By the time of two hours,one day or seven days after treatment,NIHSS score was respectively reduced comparing with that before the treatment,and the difference was statistically significant(P<0.05).NIHSS score decreased with the prolongation of time.The average time of thrombolysis was(3.14±0.58)h,the average time of drug injection was(98.26±15.23)min,and the average time of intravascular treatment was(85.17±15.16)min.The clinical effect of neurological defect score evaluation showed that one month after the operation,75 cases were cured,41 cases were effective,27 cases were ineffective,0 cases were worsened,the total effective rate was 81.12%.The prognosis of mRS scale evaluation showed that three months after the operation,97 cases of 143 patients’mRS score≤2 points,46 cases>2 points,the effective rate was 67.83%.The evaluation of vascular recanalization by Gonner score showed that 0 case were classed as grade 0 or grade 1,42 cases were classed as grade 2,101 cases as grade 3.And the vascular recanalization rate was 100.00%.Conclusion:The technique of carotid artery thrombolysis and bridging has the advantages of simple and convenient thrombolysis,high success rate and good prognosis,which is worth further exploration.

关 键 词：颈动脉溶栓 桥接 血管内技术 急性脑梗死 

分 类 号：R743.3[医药卫生—神经病学与精神病学]