动脉溶栓联合机械取栓治疗急性脑梗死的疗效及预后的影响因素  

Efficacy and prognostic factors for arterial thrombolysis combined with mechanical thrombectomy in the treatment of acute cerebral infarction

作　　者：贾冰[1] 赵晨[1] 刘靖宇 JIA Bing;ZHAO Chen;LIU Jingyu(The First Hospital of Qiqihar,Qiqihar 161000,China)

机构地区：[1]齐齐哈尔市第一医院,黑龙江齐齐哈尔161000

出　　处：《中国实用神经疾病杂志》2024年第2期206-210,共5页Chinese Journal of Practical Nervous Diseases

基　　金：黑龙江省卫生健康委员会科研项目(编号:2020HS0076)。

摘　　要：目的分析动脉溶栓联合机械取栓治疗急性脑梗死的临床疗效及预后的影响因素。方法选取2021-07—2022-12齐齐哈尔市第一医院诊治的急性脑梗死患者116例为对象,按随机数字表法分2组各58例。2组患者均采取基础治疗,对照组加用机械取栓治疗,观察组加用动脉溶栓联合机械取栓治疗。观察2组临床疗效,根据术后3个月改良Rankin量表(mRS)评估患者预后情况,分为预后良好组(mRS≤2,52例)和预后不良组(mRS≥3,64例)。收集临床资料,采用单因素和二元Logistic回归分析影响预后的独立因素。结果观察组总有效87.93%(51/58),显著高于对照组的68.97%(40/58),差异有统计学意义(P<0.05)。单因素分析显示,预后良好组与预后不良组患者年龄、侧支循环、血管再通情况、入院NIHSS评分、发病至就诊时间、治疗方式比较差异均有统计学意义(P<0.05)。以预后为因变量(1=预后良好组,2=预后不良组),以年龄、侧支循环、血管再通情况、入院NIHSS评分、发病至就诊时间、治疗方式为协变量,纳入Logistic回归模型,结果显示年龄、入院NIHSS评分、发病至就诊时间、治疗方式是影响急性脑梗死患者预后的独立因素(P<0.05)。结论动脉溶栓联合机械取栓可作为一种有效的治疗方法,患者年龄、NIHSS评分、发病至就诊时间和治疗方式应被重视,以获得更好的预后。Objective To analyze the clinical efficacy and prognostic factors for arterial thrombolysis combined with mechanical thrombectomy in the treatment of acute cerebral infarction.Methods Totally 116 patients with acute cerebral infarction diagnosed and treated in the First Hospital of Qiqihar from July 2021 to December 2022 were selected as the research subjects,and were divided into two groups by random number table method,with 58 cases in each group.Both groups received basic treatment,the control group received mechanical thrombectomy treatment,and the observation group received arterial thrombolysis combined with mechanical thrombectomy treatment.The clinical efficacy of two groups was observed,and the patient’s prognosis was evaluated based on the modified Rankin scale(mRS)at 3 months after surgery.The patients were divided into good prognosis group(mRS≤2,52 cases)and poor prognosis group(mRS≥3,64 cases).The clinical data of two groups were collected,and the independent prognostic factors were analyzed by univariate and binary Logistic regression.Results The total effective rate of 87.93%(51/58)in the observation group was significantly higher than that of 68.97%(40/58)in the control group,with a statistically significant difference(P<0.05).Univariate analysis showed that there were significant differences in age,collateral circulation,vascular recanalization,NIHSS score,time from onset to treatment,and treatment method between the two groups(P<0.05).Using prognosis as the dependent variable(1=group with good prognosis,2=group with poor prognosis)and age,collateral circulation,vascular recanalization,admission NIHSS score,onset to visit time,and treatment method as covariates,the results were analyzed in a Logistic regression model.The results showed that age,admission NIHSS score,onset to visit time,and treatment method were independent factors affecting the prognosis of patients with acute cerebral infarction(P<0.05).Conclusion Arterial thrombolysis combined with mechanical thrombectomy can be an effect

关 键 词：急性脑梗死 动脉溶栓 机械取栓 预后 影响因素 

分 类 号：R743.33[医药卫生—神经病学与精神病学]