动脉溶栓联合Solitaire AB支架治疗急性缺血性脑卒中疗效观察

Effect of arterial thrombolysis combined with Solitaire AB bracket in treatment of acute ischemic stroke

目的观察动脉溶栓联合Solitaire AB支架治疗急性缺血性脑卒中的疗效。方法选取2013年6月—2014年6月黑龙江省第三医院神经内科诊治急性缺血性脑卒中患者80例,按照抽签法随机分为观察组和对照组各40例,对照组患者采用单纯血栓通＋动脉溶栓治疗,观察组在对照组的基础上加Solitaire AB支架。比较2组临床疗效;观察2组患者血管再通情况;治疗前后进行NIHSS评分、认知评分以及日常生活活动评分;随访1年,观察复发率及病死率。结果治疗后,观察组总有效率95.00%（38/40）高于对照组77.50%（31./40）,差异具有统计学意义（χ^2=5.165,P〈0.05）;血管再通率97.50%（39/40）高于对照组82.50%（33/40）,血管再通时间（16.8±3.6）min短于对照组（28.6±7.5）min,差异具有统计学意义（χ^2=5.000,P〈0.05;t=8.970,P〈0.01）;NIHSS评分（11.2±2.7）分低于对照组（14.7±3.1）分（t=5.364,P〈0.01）,认知评分及日常生活评分[（13.3±3.5）分,（42.5土10.3）分]高于对照组[（8.2±2.2）分,（35.6±8.2）分]（t=7.831、3.324,P〈0.01）;复发率及病死率[5.00%（2/40）,0]均低于对照组[20.00%（5/40）,12.50%（5/40）],差异均有统计学意义（χ^2=4.114、5.333,P〈0.05）。结论动脉溶栓联合Solitaire AB支架在急性缺血性脑卒中患者中疗效显著,能够有效地促进血管再通,值得在临床上应用推广。

Objective To observe the curative effect of arterial thrombolysis combined with Solitaire AB stent in the treatment oi acute ischemic stroke.Methods From June 2013 to 2014 June,in the department of neurology,the third hospital of Heilongjiang Province,a total of 80 cases of acute ischemic stroke patients were enrolled,they were randomly divided into observation group and control group,40 cases in each group,the control group was treated with arterial thrombolysis,observation group was treated on the basis of the control group plus Solitaire AB stent.The clinical efficacy of 2 groups were compared,the revascularization in the 2 groups were observed,before and after treatment,NTHSS score,cognitive score and daily life activity score were observed,and after 1 years of follow-up,the recurrence rate and mortality rate were observed.Results After treatment,the total efficiency of the observation group（95.00%,38/40） was higher than 77.50%in the control group（31/40）,the difference was statistically significant（P〈0.05）;the recanalization rate of observation group（97.50%,39/40） was higher than 82.50%in the control group（33/40）,recanalization lime（16.8 ±3.6）min were shorter than the control group（28.6 ±7.5） min.the difference was statistically significant（P〈0.05）;NIHSS score（11.2 ±2.7）points was lower than that of control group（14.7 ±3.1） points,cognitive score（13.3 ±3.5）points and daily life score（42.5 ± 10.3） points were higher than that of the control group（8.2±2.2,35.6±8.2）;the recurrence rale and the mortality rate were 5.00%（2/40）,which were lower than the control group＇s 20.00%（5/40） and 12.50%（5/40）,the differences were statistically significant（P〈0.05）.Conclusion Arterial thrombolytic therapy combined with Solitaire AB stent In patients with acute ischemic stroke palients had significant effect,it can effectively promote blood vessel revascularization,il is worthy of clinical application and promotion.