静脉溶栓与机械取栓治疗急性脑梗死的临床疗效观察

OBSERVATION ON THE CLINICAL EFFECT OF INTRAVENOUS THROMBOLYSIS AND MECHANICAL THROMBUS IN ACUTE CEREBRAL INFARCTION

目的评价静脉溶栓、Solitaire AB支架机械取栓治疗急性脑梗死的疗效及安全性。方法回顾性分析急性前循环大动脉脑梗死患者75例,根据不同治疗方法分未溶栓组(26例)、静脉溶栓组(29例)、机械溶栓组(20例)、分别对治疗前后患者的美国国立卫生研究院卒中量表(NIHSS)评分、治疗的有效性、近期与远期疗效进行分析。结果与治疗前比较,静脉溶栓组(29例)、机械溶栓组治疗后2周NIHSS评分明显降低(p<0.05);与静脉溶栓组比较,机械取栓组治疗后2周NIHSS评分明显降低(p<0.05)。治疗3个月后机械取栓组mRS评分≤2分病例明显高于静脉溶栓组,差异具有统计学意义(p<0.05);三组治疗7 d内症状性颅内出血发生率比较,差异无统计学意义(p>0.05);三组治疗2 w内死亡率比较,差异无统计学意义(p>0.05)。结论 Solitaire AB支架取栓术治疗急性大动脉脑梗死临床疗效优于静脉溶栓治疗,安全性及远期临床预后较好。

Objective Efficacy and safety evaluation of intravenous thrombolysis, Solitaire AB stent mechanical thrombecto-my treatment of acute cerebral infarction.Methods We retrospectively analyzed the patient demographics, National Institute of Health Stroke Scale （NIHSS） score and modified Rankin Scale （mRS） score at the time of admission, treatment strategy, angio-graphic results using the Thrombolysis In Cerebral Infarction （ TICI） score, and clinical and imaging follow -up.Results Seventy-five patients were included.There was an absolute difference of 22.8 percentage points in the rate of functional independence （modi-fied Rankin score, 0 to 2） in favor of the intervention （40.0% vs.17.2%）.There were no significant differences in mortality or the occurrence of symptomatic intracerebral hemorrhage.Conclusion In patients with acute ischemic stroke caused by a proximal in-tracranial occlusion of the anterior circulation, intraarterial treatment administered within 6 hours after stroke onset was effective and safe.