血管内支架置入术和单纯药物治疗大脑中动脉M1段狭窄致脑梗塞的疗效观察  

EFFECT OF THERAPEUTIC EFFECTS OF ENDOVASCULAR STENTING AND DRUG THERAPY FOR CEREBRAL INFARCTION CAUSED BY MIDDLE CEREBRAL ARTERY OF M1 STENOSIS

作　　者：张洁[1] 王芳 高健 薛瑞忠 柳桂红 李冠霞 张秀娟 ZHANG Jie;WANG Fang;GAO Jian;XUE Ruizhong;LIU Guihong;LI Guanxia;ZHANG Xiujuan(Tangshan People's Hospital,TangShan 063000,China)

机构地区：[1]河北省唐山市人民医院,063000 [2]中国康复研究中心北京博爱医院

出　　处：《中国煤炭工业医学杂志》2022年第4期365-369,共5页Chinese Journal of Coal Industry Medicine

基　　金：2019年度河北省医学科学研究课题计划(编号:20191594)。

摘　　要：目的 探讨血管内支架置入术和单纯药物治疗大脑中动脉狭窄所致脑梗塞的临床疗效。方法 选取唐山市人民医院2018年1月—2020年6月收治的大脑中动脉M1段狭窄所致脑梗塞患者62例进行回顾性分析,按照治疗方法的不同分为观察组和对照组,每组各31例。观察组患者给予血管内支架置入术治疗,术后常规服用抗血栓药物。对照组给予抗血小板聚集,降血脂,降血压,改善微循环等保守治疗。两组患者的治疗均在发病6小时内进行。比较二组患者支架置入术及保守治疗半年后美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数、血管狭窄率、改良Rankin(mRS)评分的区别,比较二组患者治疗后1个月、3个月、6个月再发脑梗塞及死亡情况。结果 治疗后6个月观察组NIHSS评分、mRS评分、血管狭窄率明显低于对照组,观察组Barthel指数明显高于对照组,比较差异有统计学意义(P<0.05),治疗后6个月观察组再发脑梗塞率显著低于对照组,比较差异有统计学意义(P<0.05)。结论 与单纯药物治疗相比血管内支架置入术治疗大脑中动脉M1段狭窄效果更明显,能明显改善患者的预后情况,有更好的临床应用价值。Objective To compare the clinical effect of endovascular stent implantation and drug therapy on cerebral infarction caused by middle cerebral artery of M1 stenosis.Methods A total of sixty-two patients with cerebral infarction caused by middle cerebral artery of M1 stenosis admitted to Tangshan People’s Hospital from January 2018 to June 2020 were selected a retrospective analysis was performed and they were divided into observation and control groups according to the different treatment methods, with thirty-one cases in each group.Observation group was treated with endovascular stent implantation and routine antithrombotic drugs after operation.The control group received anti-platelet aggregation, lowering blood lipid, lowering blood pressure, improving microcirculation and other conservative treatment.Treatment was performed within 6 hours of onset in both groups.The differences of NIHSS score, Barthel index, vascular stenosis rate and modified Rankin(mRS) score were compared between the two groups after stenting and conservative treatment for half a year, and the recurrence of cerebral infarction and death at one, three and six months after treatment were compared between the two groups.Results Six months after treatment, NIHSS score, mRS score and vascular stenosis rate in the observation group were significantly lower than those in the control group, and Barthel index in the observation group was significantly higher than that in the control group, with statistically significant differences(P<0.05).Six months after treatment, the recurrence rate of cerebral infarction in the observation group was significantly lower than that in the control group, with statistically significant differences(P<0.05).Conclusion Compared with drug therapy alone, endovascular stenting is more effective in the treatment of middle cerebral artery of M1 stenosis, which can significantly improve the prognosis ofpatients and has better clinical application value.

关 键 词：大脑中动脉M1段狭窄 脑梗塞 血管内支架置入术 

分 类 号：R587[医药卫生—内分泌]