机械取栓与急诊动脉内溶栓治疗急性脑梗死患者的疗效比较  

Comparison of the Therapeutic Effects of Mechanical Thrombectomy and Emergency Intra-arterial Thrombolysis in Patients with Acute Cerebral Infarction

作　　者：许卫利 王宏宇[1] 张忆 XU Weili;WANG Hongyu;ZHANG Yi(Emergency Department,The Seventh People's Hospital of Zhengzhou,Zhengzhou Henan 450000)

机构地区：[1]郑州市第七人民医院急诊科,河南郑州450000

出　　处：《医学临床研究》2024年第9期1372-1374,共3页Journal of Clinical Research

摘　　要：【目的】比较机械取栓(MT)与急诊动脉内溶栓(IAT)治疗急性脑梗死患者的疗效。【方法】回顾性分析本院收治的118例行MT或IAT治疗的急性脑梗死患者的资料,其中,MT组66例,IAT组52例。比较两组患者的临床疗效、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、穿刺至血管再通时间、血管再通率、≤30%残余狭窄率、24 h内症状性颅内出血发生率、术后90 d病死率。【结果】MT组总有效率高于IAT组(P<0.05);治疗后3 d,两组患者NIHSS评分均低于治疗前(P<0.05),且MT组低于IAT组(P<0.05);MT组穿刺至血管再通时间短于IAT组(P<0.05),MT组血管再通率高于IAT组(P<0.05);两组患者≤30%残余狭窄率、24 h内症状性颅内出血发生率、术后90 d病死率比较,差异均无统计学意义(P>0.05)。【结论】与IAT相比,MT治疗急性脑梗死患者可以提高血管再通率,改善患者预后。【Objective】To compare the efficacy of mechanical thrombectomy(MT)and emergency intra-arterial thrombolysis(IAT)in the treatment of patients with acute cerebral infarction.【Methods】A retrospective analysis was conducted on the data of 118 patients with acute cerebral infarction treated with MT or IAT in our hospital,including 66 cases in the MT group and 52 cases in the IAT group.The clinical efficacy of two groups of patients was compared,including the National Institutes of Health Stroke Scale(NIHSS)score before and after treatment,puncture to recanalization time,vascular recanalization rate,residual stenosis rate≤30%,incidence of symptomatic intracranial hemorrhage within 24 hours,and 90 days mortality rate after surgery.【Results】The total effective rate of the MT group was higher than that of the IAT group(P<0.05);After 3 days of treatment,the NIHSS scores of both groups of patients were lower than before treatment(P<0.05),and the MT group was lower than the IAT group(P<0.05);The time from puncture to recanalization in the MT group was shorter than that in the IAT group(P<0.05),and the vascular recanalization rate in the MT group was higher than that in the IAT group(P<0.05);There was no statistically significant difference(P>0.05)in the residual stenosis rate of≤30%,the incidence of symptomatic intracranial hemorrhage within 24 hours,and the mortality rate at 90 days after surgery between the two groups of patients.【Conclusion】Compared with IAT,MT can improve vascular recanalization rate and prognosis in patients with acute cerebral infarction.

关 键 词：脑梗死/外科学 脑梗死/药物疗法 急性病 血栓溶解疗法 

分 类 号：R743.33[医药卫生—神经病学与精神病学]