支架取栓术在急性缺血性脑卒中患者中的应用效果

Application Effect of Stent Guided Thrombectomy on Acute Ischemic Stroke

目的观察支架取栓术在缺血性脑卒中患者中的应用效果。方法选取湖南省人民医院神经内科2012年10月—2016年10月收治的急性缺血性脑卒中患者60例,根据治疗方法分为对照组和观察组,每组30例。对照组患者采用重组人组织型纤溶酶原激活剂静脉溶栓治疗,观察组患者行支架取栓术。比较两组患者治疗后5 d血管再通率、治疗前和治疗后10 d美国国立卫生研究院卒中量表(NIHSS)评分、治疗后3个月预后良好率、治疗后1个月内颅内出血发生率及并发症发生情况。结果观察组患者治疗后5 d血管再通率高于对照组(P<0.05)。治疗前两组患者NIHSS评分比较,差异无统计学意义(P>0.05);治疗后10 d观察组患者NIHSS评分低于对照组(P<0.05)。治疗后3个月观察组患者预后良好率高于对照组,治疗后1个月内观察组患者颅内出血发生率低于对照组(P<0.05)。观察组患者并发症发生率低于对照组(P<0.05)。结论支架取栓术在急性缺血性脑卒中患者中的应用效果良好,能有效提高患者血管再通率,改善患者早期神经功能及远期预后,降低颅内出血发生率,且安全性较高。

Objective To observe the application effect of stent guided thrombectomy on acute ischemic stroke. Methods From October 2012 to October 2016, a total of 60 patients with acute isehemic stroke were selected in the Department of Neurology, the People＇s Hospital of Hu＇nan, and they were divided into control group and observation group according to therapeutic methods, each of 30 cases. Patients of control group received recombinant tissue plasminagen activator for thrombelytie therapy, while patients of observation group received stent guided thrombeetomy. Vascular reeanalization rate after 5 days of treatment, NIHSS score before treatment and after 10 days of treatment, proportion of patients with favourable prognosis after 3 months of treatment, incidence of intracranial hemorrhage within 1 month after treatment and incidence of complications were compared between the two groups. Results Vascular recanalization rate of obsexvafion group was statistically srignifieantly higher than that of control group after 5 days of treatment （ P 〈 0. 05）. No statistically significant differences of lgIHSS score was found between the two groups before treatment （P 〉0. 05）, while NIHSS of observation group was statistically significantly lower than that of control group after 10 days of treatment （ P 〈0. 05 ）. Proportion of patients with favourable prognosis af observation group was statistically significantly higher than that of control gnmp after 3 months of treatment, while incidence of intracranial hemorrhage of observation group was statistically significantly lower than that of control group within 1 month after treatment （ P 〈 0. 05）. Incidence of complications of observation group was statistically signiticantly lower than that of corarol group （ P 〈 0. 05）. Conclusion Stent guided thrombectomy has good application effect in treating acute ischemic stre, can effectively improve the vascular recanalization rate,＇ recent neurological function and long - term ptagnosis, reduce the risk of intracranial hemorrhage, with relatively high safety.