临床荟萃

• 论著 • 上一篇    下一篇

支架取栓与静脉溶栓治疗急性大动脉闭塞型脑梗死的疗效对比

  

  1. 贺州市人民医院 神经内科,广西  贺州  542899
  • 出版日期:2019-07-20 发布日期:2019-08-24
  • 通讯作者: 毛献泉, Email:maoxianquan@tom.com
  • 基金资助:
    贺州市科技成果转化与推广及产业化示范项目----TREVO取栓支架与静脉溶栓治疗急性大动脉闭塞型脑梗死疗效对比(贺科转201808039)

Clinical efficacy of mechanical thrombectomy and intravenous thrombolysis to  acute aortic occlusive stroke

  1. Department of Neurology, Hezhou People’s Hospital, Hezhou 542899,  China
  • Online:2019-07-20 Published:2019-08-24
  • Contact: Corresponding author: Mao Xianquan, Email:maoxianquan@tom.com

摘要: 目的  探讨急性大动脉闭塞型脑梗死患者支架取栓治疗的疗效和安全性。方法  选取2016年4月至2019年4月在贺州市人民医院神经内科住院的急性大动脉闭塞型脑梗死患者65例,随机分为支架取栓治疗组及静脉溶栓治疗组,其中支架取栓治疗组35例,静脉溶栓治疗组30例,通过比较两组基线资料、血管再通率、治疗后24小时、14天的NIHSS评分改善情况、90天神经功能恢复评分(mRS)、治疗期间颅内出血转化、临床死亡率等,评估两组治疗方法的疗效及安全性。 结果  支架取栓组治疗后24小时、14天NIHSS评分较静脉溶栓组均有明显下降(均P<0.05),90天神经功能恢复良好率(mRS 0~2分)支架取栓治疗组(54.28%)明显高于静脉溶栓治疗组(24.33%)(P<0.05),支架取栓治疗组血管再通率(85.7%)显著高于静脉溶栓治疗组(16.67%)(P<0.05);两组间的总颅内出血转化风险及各亚型颅内出血转化风险比较差异无统计学意义(P>0.05)。结论  支架取栓治疗急性大动脉闭塞型脑梗死效果较静脉溶栓更好。

关键词: 脑梗塞, 梗塞,  , 大脑中动脉, 支架取栓, 血栓溶解疗法, 治疗结果

Abstract: Objective  To investigate the safety and clinical efficacy of mechanical thrombectomy to acute aortic occlusive stroke. Methods  Sixtyfive patients with acute aortic occlusive stroke who admitted to the hospital from April 2016 to April 2019 were divided into   mechanical thrombectomy group (35 patients) and intravenous thrombolysis group(30 patients).  Comparison was performed in the baseline data,  recanalization rate,  NIHSS score at 24 h and 14 d after treatment,  90day neurological recovery score (90 d mRS),  intracranial hemorrhage during treatment transformation,  clinical mortality to evaluate the efficacy and safety between  two groups. Results  The NIHSS scores of  mechanical thrombectomy group were significantly lower than those of  intravenous thrombolysis group at 24 h and 14 d after treatment (P<0.05). The 90 d mRS of mechanical thrombectomy group(54.28%)   was significantly higher than that of intravenous thrombolysis group(24.33%)(P<0.05).The recanalization rate of mechanical thrombectomy group(85.7%) was significantly higher than that of intravenous thrombolysis group(16.67%)(P<0.05). Conclusion  The clinical efficacy of  mechanical thrombectomy to  acute aortic occlusive stroke is better than that of intravenous thrombolysis.

Key words: brain infarction;infarction, middle cerebral artery, thrombolysis therapy;treatment outcome