老年急性缺血性脑卒中多模式血管内治疗的有效性和安全性研究  

The effectiveness and safety of multimodal endovascular treatment for acute ischemic stroke in elderly patients

作　　者：张丽娜 王敏 邓榕 雷达 王勇 陈胜利 Zhang Lina;Wang Min;Deng Rong;Lei Da;Wang Yong;Chen Shengli(Department of Neurology,Chongqing University Three Gorges Hospital,Chongqing 404000,China)

机构地区：[1]重庆大学附属三峡医院神经内科,404000

出　　处：《中华老年医学杂志》2021年第5期580-582,共3页Chinese Journal of Geriatrics

基　　金：重庆市卫生和计划生育委员会医学科研计划项目(2016MSXM113)。

摘　　要：目的评价多模式血管内治疗急性缺血性卒中老年患者的疗效和安全性。方法选择2017年1月至2018年12月间收治的263例老年急性缺血性卒中颅内大血管闭塞患者作为本次研究对象,根据前瞻性分组法将患者分为静脉溶栓治疗组与血管内治疗组。使用美国国立卫生研究院卒中量表(NIHSS)评分及90 d改良Rankin(mRS)评分,比较各组患者的治疗效果。结果共纳入263例患者,其中静脉溶栓治疗组125例,血管内治疗组138例。(1)血管内治疗组优良率高于静脉溶栓治疗组(97.8%和91.2%,χ^(2)=5.713,P<0.05);(2)血管内治疗组NHISS评分[(2.3±0.3)分和(6.0±1.8)分,t=9.067,P<0.05]、mRS评分[(1.1±0.1)分和(2.3±0.3)分,t=16.970,P<0.05]低于静脉溶栓治疗组;(3)不良反应发生率血管内治疗组和静脉溶栓治疗组比较差异无统计学意义(8.6%和8.0%,χ^(2)=0.041,P>0.05)。结论多模式机械取栓是急性缺血性卒中颅内大血管闭塞安全有效的治疗方法,具有应用与推广价值。Objective To evaluate the efficacy and safety of multimodal endovascular therapy for acute ischemic stroke in elderly patients.Methods A total of 263 elderly patients with acute ischemic stroke were enrolled as research subjects from January 2017 to December 2018.Patients were divided into two groups:the intravenous thrombolytic therapy group and the endovascular therapy group.Treatment outcomes were compared by using the National Institutes of Health Stroke Scale(NIHSS)and the modified Rankin Scale(mRS).Results Of 263 patients,125 were in the intravenous thrombolytic therapy group and 138 were in the intravascular therapy group.The rate of good/excellent outcomes was higher in the endovascular treatment group than in the intravenous thrombolytic therapy group(97.8%vs.91.2%,χ^(2)=5.713,P<0.05).The NIHSS score and mRS score were lower in the endovascular treatment group than the in intravenous thrombolytic therapy group[(2.3±0.3)vs.(6.0±1.8),(1.1±0.1)vs.(2.3±0.3),t=9.067 and 16.970,P<0.05].There was no significant difference in the incidence of adverse reactions between the two groups(8.6%vs.8.0%,χ^(2)=0.041,P>0.05).Conclusions Multimodal mechanical thrombus retrieval is a safe and effective treatment for intracranial large vessel occlusion in acute ischemic stroke patients and should be recommended and promoted.

关 键 词：卒中 多模式血管内治疗 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]