单纯机械取栓与联合静脉溶栓治疗前循环颅内大动脉闭塞急性脑梗死患者临床观察  

Clinical observation of mechanical thrombectomy versus combined with intravenous alteplase after stroke with intracranial anterior large-vessel occlusions

作　　者：郭耀强 白宏英[2] 录海斌 刘海涛[1] 赵祚翔 GUO Yaoqiang;BAI Hongying;LU Haibin;LIU Haitao;ZHAO Zuoxiang(People’s Hospital of Zhengzhou,Zhengzhou 450003,China;The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院,河南郑州450003 [2]郑州大学第二附属医院,河南郑州450003

出　　处：《中国实用神经疾病杂志》2021年第14期1239-1245,共7页Chinese Journal of Practical Nervous Diseases

基　　金：河南省医学科技攻关项目(编号:LHGJ20191066)。

摘　　要：目的观察单纯机械取栓与联合静脉溶栓治疗前循环颅内大动脉闭塞急性脑梗死患者的疗效与安全性。方法采用回顾性分析,研究样本为2016-06—2020-05在郑州人民医院卒中中心接受诊疗及90 d随访的前循环大动脉病变急性脑梗死患者124例,对照组53例患者接受单纯机械取栓治疗,观察组71例患者接受机械取栓联合静脉溶栓治疗,比较2组患者90 d后改良Rankin量表(mRS)评分、24 h内症状性颅内出血发生率及90 d随访期内全因死亡发生率。结果治疗前2组NIHSS评分及其他基本信息比较差异无统计学意义(P>0.05);观察组90 d后良好预后(mRS≤2分)略优于对照组,但差异无统计学意义(P>0.05);24 h内症状性颅内出血发生率观察组略高,但2组比较差异无统计学意义(P>0.05);90 d全因死亡发生率2组间无显著差异(P>0.05)。结论单纯机械取栓与联合溶栓治疗对前循环颅内大动脉闭塞急性脑梗死患者的有效性与安全性相当。Objective To determine whether mechanical thrombectomy in addition to intravenous thrombolysis improves clinical outcome in acute ischemic stroke patients with intracranial anterior large-vessel occlusions.Methods Totally 124 in-hospital patients were retrospectively analyzed from July 2016 to June 2020 in Stroke Center Department of People’s Hospital of Zhengzhou.All patients suffered from acute stroke with intracranial anterior artery occlusion and accepted a 90-day follow-up.Fifty-three cases of control group were treated by mechanical thrombectomy,while 71 cases of treatment group accepted mechanical thrombectomy combined with intravenous alteplase.Main outcomes were functional independence,defined as a modified Rankin Scale score of 0-2.The occurrence of symptomatic intracranial hemorrhage at the first 24 hours and mortality for all cause at 90 days after onset of symptoms were set as the safety endpoints.Results There was no statistically difference of baseline information between the two groups before treatment(P>0.05).Ninety days later,patients of the treatment group had lower mRS score than the control group while there was no statistical significance(P>0.05).The two groups had no significant differences in symptomatic intracranial hemorrhage at 24 hours or mortality at 3 months(P>0.05).Conclusion For acute stroke patients with intracranial anterior artery occlusion,the efficacy and safety of mechanical thrombectomy and combined with standard intravenous thrombolysis are similar.

关 键 词：前循环急性脑梗死 机械取栓 联合静脉溶栓 有效性 安全性 

分 类 号：R743.33[医药卫生—神经病学与精神病学]