机械取栓与动脉内溶栓在急性脑梗死患者中的应用效果比较  

Comparison of application effect of mechanical thrombectomy and intra-arterial thrombolysis in patients with acute cerebral infarction

作　　者：王黎明 杨丹丹 陈静 蔡丹丹 张雪玲 WANG Liming;YANG Dandan;CHEN Jing;CAI Dandan;ZHANG Xueling(Department of Neurology,Suqian Hospital Affiliated to Xuzhou Medical University,Jiangsu Province,Suqian 223800,China)

机构地区：[1]徐州医科大学附属宿迁医院神经内科,江苏宿迁223800

出　　处：《中国医药导报》2023年第32期98-101,共4页China Medical Herald

基　　金：江苏省宿迁市科技项目(S201714)。

摘　　要：目的探讨机械取栓(MT)及动脉内溶栓(IAT)在急性脑梗死患者中应用效果。方法将徐州医科大学附属宿迁医院2021年1月至2022年7月收治的120例急性脑梗死患者纳入研究,根据不同治疗方法将其分为取栓组及溶栓组,各60例。取栓组接受MT治疗,溶栓组接受IAT治疗。记录比较两组临床疗效,比较两组血管再通情况,检测两组手术前后神经功能指标[美国国立卫生研究院卒中量表(NIHSS)评分、神经元特异性烯醇化酶(NSE)、S100β蛋白(S100β)、脑源性神经营养因子(BDNF)],记录比较两组并发症及预后情况。结果取栓组临床疗效优于溶栓组,差异有统计学意义(P<0.05)。取栓组血管情况优于溶栓组,差异有统计学意义(P<0.05)。术后1周,两组NIHSS评分、NSE、S100β水平较术前降低,BDNF水平较术前升高,且取栓组NIHSS评分、NSE、S100β水平低于溶栓组,BDNF水平高于溶栓组,差异有统计学意义(P<0.05)。取栓组并发症总发生率、死亡率均低于溶栓组,差异有统计学意义(P<0.05)。结论MT对急性脑梗死患者的治疗效果明显优于IAT,能够有效帮助血管复通,同时改善患者术后神经功能,减少并发症及死亡率发生。Objective To explore the application effect of mechanical thrombectomy(MT)and intra-arterial thrombolysis(IAT)in patients with acute cerebral infarction.Methods A total of 120 patients with acute cerebral infarction admitted to Suqian Hospital Affiliated to Xuzhou Medical University from January 2021 to July 2022 were included in the study and they were divided into thrombectomy group and thrombolysis group according to different treatment methods,with 60 cases in each group.The thrombectomy group received MT and the thrombolysis group received IAT.The clinical efficacy of the two groups was recorded and compared,the vascular recirculation condition of the two groups was compared,and the levels of neurological function indicators(National Institutes of Health stroke scale[NIHSS]score,neuron specific enolase[NSE],S100βprotein[S100β],brain-derived neurotrophic factor[BDNF])before and after surgery of the two groups were measured and compared.Complications and prognosis of the two groups were recorded and compared.Results The clinical effect of thrombectomy group was better than that of thrombolysis group,and the difference was statistically significant(P<0.05).The vascular condition of thrombectomy group was better than that of thrombolysis group,and the difference was statistically significant(P<0.05).One week after surgery,the NIHSS score,NSE,and S100βlevels of the two groups were decreased,while the BDNF level was increased,and the NIHSS score,NSE,and S100βlevels of the thrombectomy group were lower than those of the thrombolysis group,while the BDNF level of the thromectomy group was higher than that of the thrombolysis group,and the differences were statistically significant(P<0.05).The incidence of complications and mortality in thrombectomy group were lower than those in thrombolysis group,and the differences were statistically significant(P<0.05).Conclusion The therapeutic effect of MT on patients with acute cerebral infarction is significantly better than that of IAT,which can effectively help vascular

关 键 词：急性脑梗死 机械取栓 动脉内溶栓 血管再通率 预后 

分 类 号：R74[医药卫生—神经病学与精神病学]