3D-DSA与2D-DSA引导支架取栓术联合静脉溶栓对老年急性脑梗死的临床疗效  

Clinical efficacy of 3D-DSA and 2D-DSA guided stent thrombectomy combined with intravenous thrombolysis for elderly patients with acute cerebral infarction

作　　者：周高领 何庆 刘鹏飞 ZHOU Gaoling;HE Qing;LIU Pengfei(Zhoukou First People's Hospital,Zhoukou 466700,Henan)

机构地区：[1]周口市第一人民医院,河南周口466700

出　　处：《菏泽医学专科学校学报》2025年第1期5-8,共4页Journal of Heze Medical College

摘　　要：目的回顾性探究三维-数字减影全脑血管造影(3D-DSA)与二维-数字减影全脑血管造影(2D-DSA)引导支架取栓术联合静脉溶栓在老年急性脑梗死中的治疗价值。方法选择我院收治的老年急性脑梗死患者80例,根据手术方法分为两组,均予以阿替普酶静脉溶栓,同时行3D-DSA引导支架取栓术治疗的40例为3D组,行2D-DSA引导支架取栓术治疗的40例为2D组。对比两组血管再通率、美国国立卫生院卒中量表(NIHSS)评分、改良Barthel量表(MBI)评分、S100钙结合蛋白β(S100β)、神经元特异性烯醇化酶(NSE)、神经肽Y(NPY)、一氧化氮(NO)、内皮素(ET)及并发症发生率。结果3D组血管再通率高于2D组(P<0.05);术后3d、7d、30d 3D组NIHSS评分低于2D组,MBI评分高于2D组(P<0.05);术后7d 3D组S100β、NSE、NPY、ET低于2D组(P<0.05),NO水平高于2D组(P<0.05);两组并发症发生率比较,P>0.05。结论与2D-DSA相比,3D-DSA引导支架取栓术联合静脉溶栓治疗老年急性脑梗死,能提高血管再通率,减轻神经功能、血管内皮功能损伤,改善生活质量。Objective To retrospectively explore the therapeutic value of stent thrombectomy guided by three-dimensional-digital subtraction angiography(3D-DSA)and two-dimensional-digital subtraction angiography(2D-DSA)combined with intravenous thrombolysis in the treatment of elderly patients with acute cerebral infarction.Methods 80 elderly patients with acute cerebral infarction were collected and divided into two groups based on surgical methods.Both groups received intravenous thrombolysis with alteplase,while 40 patients in the 3D group underwent 3D-DSA-guided stent thrombectomy and 40 patients in the 2D group underwent 2D-DSA-guided stent thrombectomy.The vascular recanalization rate,National Institutes of Health Stroke Scale(NIHSS)score,modified Barthel Index(MBI)score,S100 calcium-binding proteinβ(S100β),neuron-specific enolase(NSE),neuropeptide Y(NPY),nitric oxide(NO),endothelin(ET),and complication rate were compared between the two groups.Results The recanalization rate of 3D group was higher than that of 2D group(P<0.05);3d,7d,and 30d after surgery,the NIHSS score of 3D group was lower than that of 2D group,and the MBI score of 3D group was higher than that of 2D group(P<0.05);after surgery of 7d,S100β,NSE,NPY and ET in 3D group were lower than those in 2D group,NO level was higher than that in 2D group(P<0.05);there was no significant difference in the incidence of complications between 3D group(5.00%)and 2D group(10.00%)(P>0.05).Conclusion Compared with 2D-DSA,3D-DSA-guided stent thrombectomy combined with intravenous thrombolysis for the treatment of acute cerebral infarction in the elderly can improve the rate of vascular recanalization,reduce neurological and vascular endothelial function damage,and improve quality of life.

关 键 词：3D-DSA 2D-DSA 支架取栓术 静脉溶栓 急性脑梗死 

分 类 号：R651.12[医药卫生—外科学]