Solitaire支架机械取栓与动脉溶栓治疗急性脑梗死的效果及对患者血清炎症因子的影响  

Comparative Study of Clinical Efficacy and the Change of Inflammatory Factors Between the Solitaire Mechanical Thrombectomy and Arterial Thrombolysis in Treatment of Acute Cerebral Infarction

作　　者：李涛 LI Tao(Xuchang Central Hospital,Xuchang Henan,461000)

机构地区：[1]许昌市中心医院神经内科,河南许昌461000

出　　处：《医学临床研究》2021年第4期536-538,542,共4页Journal of Clinical Research

摘　　要：[目的]探讨Solitaire支架机械取栓与动脉溶栓治疗急性脑梗死的效果及对患者血清炎症因子的影响。[方法]回顾性分析2017年6月至2019年7月本院收治的60例急性脑梗死患者的临床资料,根据治疗方式的不同分为溶栓组(行微导管置于阻塞血管近端或阻塞血管血栓内的尿激酶溶栓治疗)与取栓组(行.Solitaire AB支架取栓治疗),各30例。比较两组治疗前后NIHSS评分、出血率、血管再通率及血清炎性因子水平的变化。[结果]与术前相比,两组患者术后24 h、1周NIHSS评分呈降低趋势,溶栓组术后1周NIHSS评分显著高于取检组,差异均有统计学意义(均P<0.05)。治疗后,溶栓组出血发生率为16.7%(5/30),高于取栓组的6.7%(2/30),但两组比较差异无统计学意义(X^(2)=1.456,P=0.228>0.05)。溶栓组血管再通率为70.0%(21/30),低于取栓组的90.0%(27/30),但两组比较差异无统计学意义(X^(2)=3.75,P=0.053>0.05)。与治疗前比较,两组患者术后d,血清IL-6、TNF-a、hs-CRP水平高于术前,术后d_(14)低于术前,术后d_(7)、d_(14)血清MMP-9水平均低于治疗前,差异均有统计学意义(P<0.05)。两组患者术后d_(7)、d_(14)血清IL-6、TNF-a.hs-CRP、MMP-9比较,差异无统计学意义(P>0.05)。[结论]Solitaire支架机械取栓与动脉溶栓比较,神经功能恢复更好,出血发生率小,术后炎症反应较轻,有利于术后恢复。[Objective]To investigate the clinical eficacy and the change of inflammatory factors between the Solitaire mechanical thrombectomy and arterial thrombolvsis in treatment of acute cerebral infarction.[Methods]The clinical data of 60 patients with acute cerebral infarction treated in our hospital from June 2017 to July 2019 were analyzed retrospectively.The patients were divided into thrombolysis group(30 patients ap-plied with the intra-arterial thrombolys)and thrombectomy group(30 patients received mechanical thrombee-tomy)according to the different treatment methods.The NIHSS score after the treatment.cure rate,bleeding rate,the TICI rating to assess the interventional recanalization and the change of inflammatory factors were detected.[Results]The NIHSS score of thrombectomy group was better than that of the thrombolysis group in a week after the treatment(P<0.05).The total effective rate reached 70.0%in the mechanical thrombecto-my group and 50.0%in the arterial thrombolysis group(P<0.05).The bleeding rate was 6.7%in thrombee-tomy group,lower than thrombolysis group,the difference was significant(P<0.05).The recanalization rate was lower in thrombectomy group(P<0.05).The value of serum IL-6.TNF-a.hs-CRP at first.sev-enth and fourteenth day of treatment increased first and decreased afterward,MMP-9 showed a decreasing trend.[Conclusion]Compared to thrombolysis.thrombectomy can provide higher effective rate,lower bleed-ing rate and is beneficial to postoperative recovery.

关 键 词：脑梗死/外科学 急性病 血栓溶解疗法 治疗结果 白细胞介素6/血液 

分 类 号：R743.33[医药卫生—神经病学与精神病学]