桥接治疗与直接介入治疗在高龄老年急性缺血性脑卒中的临床疗效  

Clinical efficacy of bridging therapy and direct intervention therapy in elderly patients with acute ischemic stroke

作　　者：田晓娜 李硕 白云 TIAN Xiaona;LI Shuo;BAI Yun(Intensive Care Unit,Shenyang Orthopedic Hospital,Shenyang,Liaoning,110041,China)

机构地区：[1]沈阳市骨科医院重症监护室,辽宁沈阳110041

出　　处：《当代医学》2023年第12期130-132,共3页Contemporary Medicine

摘　　要：目的探讨桥接治疗与直接介入治疗在老年急性缺血性脑卒中(AIS)的临床疗效。方法选取2019年1月至2020年10月本院收治的120例AIS患者作为研究对象,按照不同治疗方法分为桥接组与直接组,各60例。直接组行直接机械取栓,桥接组在机械取栓前给予静脉溶栓,比较两组3个月内出血症状性颅内出血发生率、病死率、取栓≤2次成功再通率及治疗后7 d、3个月改良Rankin评分量表评分。结果两组出血症状性颅内出血发生率、3个月病死率比较差异无统计学意义;桥接组取栓≤2次成功再通率为75.00%,高于直接组的55.00%,差异有统计学意义(P<0.05)。两组治疗后7 d、3个月mRS评分组内比较差异无统计学意义;治疗后3个月,两组mRS评分均低于治疗后7 d,差异有统计学意义(P<0.05)。结论桥接治疗和直接介入治疗对发病≤4.5 h到院的≥70岁AIS患者同样安全有效,且桥接治疗取栓≤2次成功再通率较高,值得临床推广应用。Objective To analyze the application of bridging therapy and direct interventional therapy in the elderly with acute ischemic stroke.Methods 120 patients with AIS admitted to our hospital from January 2019 to October 2020 were selected as the research subjects,and they were divided into the bridging group and the direct group according to different treatment methods,with 60 cases in each group.The direct group was di-rectly mechanically thrombolytic;the bridging group was given intravenous thrombolysis before the mechanical thrombolysis,the incidence of symp-tomatic intracranial hemorrhage within 3 months,mortality,the rate of≤2 successful revascularization after thrombectomy and the score of the modi-fied Rankin score scale 7 d and 3 months after treatment were compared between the two groups.Results There was no statistically significant differ-ence in the incidence of symptomatic intracranial hemorrhage and 3-month mortality between the two groups;the successful recanalization rate in the bridging group was 75.00%,which was higher than the 55.00%in the direct group,the difference was statistically significant(P<0.05).There was no statistically significant difference in mRS scores between the two groups at 7 d and 3 months after treatment;After 3 months of treatment,the mRS scores of the two groups were lower than those in 7 d after treatment,and the difference was statistically significant(P<0.05).Conclusion Bridging therapy and direct interventional therapy are equally safe and effective for AIS patients≥70 years old who arrive at the hospital less than 4.5 h after onset,and the bridging therapy has a high success rate of≤2 times of thrombus removal,which is worthy of clinical promotion and application.

关 键 词：桥接治疗 直接介入治疗 急性缺血性脑卒 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]