介入治疗对腔隙性脑梗死患者认知功能的影响

Influence of interventional therapy on cognitive function in patients with lacunar cerebral infarction

目的探讨介入治疗对腔隙性脑梗死的临床效果及其对患者认知变化的影响。方法 112例腔隙性脑梗死患者,按随机数字表法分为观察组和对照组,每组56例。对照组给予常规治疗方法进行干预;观察组给予介入治疗,当导管介入到狭窄或闭塞血管位置时,给予50万单位尿激酶缓慢注射,并使用微导丝器械进行配合取栓。比较两组患者治疗效果及认知功能的变化。结果治疗后观察组总有效率为96.43%(54/56),明显高于对照组的85.71%(48/56),差异有统计学意义(P<0.05)。治疗前,两组患者MMSE、Mo CA评分比较,差异无统计学意义(P>0.05);治疗后1个月、6个月,观察组MMSE、Mo CA评分均高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者SAS、SDS评分比较,差异均无统计学意义(P>0.05);治疗后1个月、6个月,观察组SAS、SDS评分均低于对照组,差异有统计学意义(P<0.05)。治疗过程中观察组并发症发生率为5.36%(3/56),明显低于对照组的14.29%(8/56),两组比较,差异有统计学意义(P<0.05)。结论介入术治疗腔隙性脑梗死效果显著,术后并发症较少,患者心理状态好,认知功能改善显著,值得临床推广应用。

Objective To investigate the clinical effects of interventional therapy in the treatment of lacunar cerebral infarction and its effect on patients＇ cognitive changes. Methods A total of 112 patients with lacunar cerebral infarction were divided into observation group and control group,56 cases in each group.Patients in control group were treated with routine treatment; patients in observation group were treated with interventional therapy,When the catheter was involved in the stenosis or occlusion of the vessel,500 thousand units of urokinase were injected slowly,then the thrombus were carried out guided by a micro-guidewire. The therapeutic effects and the changes of cognitive function in the two groups were compared after treatment.Results After treatment,the total effective rate of observation group was 96. 43%（ 54/56）,significantly higher than 85. 71%（ 48/56） of control group,the difference was statistically significant（ P〈0. 05）. Before treatment,the MMSE,Mo CA scores of two groups was not statistically significant（ P〉0. 05）; after 1 month,6 months of treatment,the MMSE and MOCA scores of observation group were higher than those of the control group,the difference was statistically significant（ P〈0. 05）. Before treatment,the SAS,SDS scores of two groups was not statistically significant（ P〉0. 05）; after 1 month,6 months of treatment,the SAS,SDS scores of observation group were lower than those of the control group,the difference was statistically significant（ P〈0. 05）. During the treatment,the incidence of complications in observation group was 5. 36%（ 3/56）,significantly lower than 14. 29%（ 8/56） of the control group,the difference was statistically significant（ P〈0. 05）. Conclusion Interventional therapy in the treatment of lacunar infarction has significant effect,less postoperative complications,good psychological state of patients,and with cognitive function improved significantly; it is worthy of clinical application.