动静脉联合溶栓及机械取栓治疗急性脑梗死对比分析

Comparative analysis on combined intravenous and intraarterial thrombolysis and mechanical thrombectomy in the treatment of ACI

目的对比动静脉联合溶栓与机械取栓治疗急性脑梗死临床效果及预后情况。方法回顾性分析我院2008-01—2013-06收治的急性脑梗死患者80例,其中采用动静脉联合溶栓治疗42例,采用机械取栓治疗38例。通过Barthel评分判定治疗效率,采用心肌梗死溶栓分级标准(TIMI)判定血管再通率,对比2组有效率、血管再通率以及近期与远期预后效果。结果动静脉联合溶栓治疗组与机械取栓组治疗有效率分别为97.6%、100%,差异无统计学意义(P>0.05);血管再通率为71.4%,100%;残余狭窄率≤30%者分别为45.2%、15.7%(P<0.05);急性血管再闭塞率分别47.6%、0(P<0.05);病死率分别为11.9%、0。结论动静脉联合溶栓及机械取栓治疗有效率相近,但机械取栓组近期及远期预后情况远优于动静脉联合溶栓组。采用机械取栓治疗急性脑梗死疗效显著、安全性高、后期预后较好,值得临床推广。

Objective To comparatively analyze clinical efficacy and prognosis of arteriovenous joint thrombolysis and me-chanical thrombectomy for acute cerebral infarction. Methods Retrospective analysis was made about 80 patients with acute cerebral infarction our hospital received from January 2008 to June 2013 ,including the use of combined intravenous thrombolyt-ic therapy in 42 cases ,the use of mechanical thrombectomy treatment in 38 cases.Barthel score is determined by means of the treatment efficiency ;thrombolysis in myocardial ischemia （TIMI） was used to identify the recanalization.The data of two groups of patient’s treatment ,short-term and long-term prognosis were analyzed comparatively.Results Arteriovenous com-bined thrombolytic therapy group and mechanical thrombectomy group ：efficiency of treatment were 95% ,100% respectively , no significant difference （P＆gt;0.05）;the recanlization rates were 71.4% ,100% ;≤30% residual stenosis rates were 45.2% , 15.7% （P＜0.05）;acute vascular occlusion rates were 47.6% ,0 （P＜0.05）;mortality was 11.9% ,0（P＜0.05） .Conclusion Arteriovenous combined thrombolysis and mechanical thrombectomy efficiency of two groups was similar ,there was no sig-nificant difference. However ,mechanical thrombectomy group’s short and long term prognosis is far superior to that of arteri-ovenous thrombolysis group. The effect ,safety ,late prognosis of mechanical thrombectomy for acute cerebral infarction are good and worthy of promotion.