TREVO支架取栓联合替罗非班在急性前循环大血管闭塞患者中的应用分析  

TREVO stent thrombotomy combined with tirofiban in patients with acute large-artery occlusion of the anterior circulation

作　　者：王彦平[1] 温昌明[1] 张保朝[1] 闻公灵[1] 孙军[1] 刘义锋[1] 汪宁[1] 钱晓宇 Wang Yanping;Wen Changming;Zhang Baochao;Wen Gongling;Sun Jun;Liu Yifeng;Wang Ning;Qian Xiaoyu(Department of Neurology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]南阳市中心医院神经内科,473000

出　　处：《中华神经医学杂志》2021年第1期29-34,共6页Chinese Journal of Neuromedicine

基　　金：河南省2019年科技发展计划项目(192102310349)。

摘　　要：目的分析TREVO支架取栓联合替罗非班治疗急性前循环大血管闭塞患者的临床效果。方法将南阳市中心医院神经内科自2016年11月至2020年5月收治的72例急性前循环脑梗死取栓患者纳入研究并按不同治疗方法分为2组;对照组(35例)采用TREVO支架取栓术治疗,治疗组(37例)采用TREVO支架取栓术联合动脉内替罗非班治疗。比较2组患者血管再通成功率、具体取栓情况、神经功能缺损改善程度、凝血功能、90 d预后及并发症发生情况。结果治疗组、对照组患者术后血管再通成功率分别为91.89%(34/37)、88.57%(31/35),差异无统计学意义(P>0.05)。治疗组患者取栓时间、取栓次数均少于对照组,差异有统计学意义(P<0.05)。术后14 d治疗组患者美国国立卫生研究院卒中量表(NIHSS)评分较对照组明显降低,差异有统计学意义(P<0.05)。治疗组患者术后凝血酶时间(TT)、凝血酶原时间(PT)及活化部分凝血酶时间(APTT)均明显高于对照组,差异有统计学意义(P<0.05)。治疗组、对照组患者90 d预后良好率分别为86.49%(32/37)、60.0%(21/35),差异有统计学意义(P<0.05);并发症发生率分别为8.11%(3/37)、14.29%(5/35),差异无统计学意义(P>0.05)。结论TREVO支架取栓术联合替罗非班治疗急性前循环大血管闭塞效果显著,安全性高。Objective To analyze the clinical effect of TREVO stent thrombectomy combined with tirofiban on patients with acute large-artery occlusion of the anterior circulation.Methods Seventy-two patients with acute large-artery occlusion of the anterior circulation accepted thrombectomy in our hospital from November 2016 to May 2020 were divided into two groups according to different treatment methods:35 patients in the control group were treated with TREVO stent thrombectomy,and 37 patients in the treatment group were treated with TREVO stent thrombectomy combined with tirofiban via intra-variceal injection.The success rate of recanalization,specific conditions of thrombolysis,improvement degrees of nerve defect,coagulation function,prognoses 90 d after thrombectomy,and complications were compared between the two groups.Results The success rate of postoperative vascular recanalization in the treatment group and control group was 91.89%(34/37)and 88.57%(31/35),respectively,without statistically significant difference(P>0.05).The time and times of thrombotomy in the treatment group were significantly shorter/smaller than those in the control group(P<0.05).The National Institute of Health stroke scale(NIHSS)scores of patients from the treatment group 14 d after thrombectomy were significantly lower than those of the control group(P<0.05).The postoperative thrombin time,prothrombin time,and activated partial thrombin time of the treatment group were significantly longer than those of the control group(P<0.05).The good prognosis rate of patients in the treatment group and control group 90 d after thrombectomy was 86.49%(32/37)and 60.0%(21/35),with significant differences(P<0.05);and the incidence of complications was 8.11%(3/37)and 14.29%(5/35),without significant differences(P>0.05).Conclusion TREVO stent thrombectomy combined with tirofiban has a significant effect on treatment of acute large-artery occlusion of the anterior circulation,enjoying high safety.

关 键 词：脑梗死 大血管闭塞 机械取栓 替罗非班 

分 类 号：R743.33[医药卫生—神经病学与精神病学]