Solitaire AB支架取栓术联合动脉注射rt-PA治疗AICVD的疗效分析

Effects of Solitaire AB stent thrombectomy combined with arterial injection of rt-PA in treatment of AICVD

目的探讨Solitaire AB支架取栓术联合动脉注射重组组织型纤溶酶原活化剂(rt-PA)治疗急性缺血性脑卒中(AICVD)的疗效。方法将60例AICVD患者等分为联合组和rt-PA组,rt-PA组仅接受动脉注射rt-PA治疗,联合组在rt-PA组基础上给予Solitaire AB支架取栓术,比较两组临床疗效、血管再通情况、预后及安全性。结果联合组治疗总有效率显著高于rt-PA组(P <0.05);在术后3 d、1个月,联合组血管再通率均高于rt-PA组(P <0.05);治疗后,两组美国国立卫生院卒中量表(NIHSS)评分均降低,而格拉斯哥昏迷量表(GCS)评分均升高(P <0.05),且联合组改善幅度大于rt-PA组(P <0.05);术后3个月,联合组改良Rankin量表(mRS)评分低于rt-PA组(P <0.05);术后两组症状性颅内出血、再灌注损伤、继发性脑栓塞发生率及病死率均无显著差异(P> 0.05)。结论 Solitaire AB支架取栓术联合动脉注射rt-PA治疗AICVD的疗效确切,患者预后良好,且安全性较高。

Objective To explore the effects of Solitaire AB stent thrombeetomy combined with arterial injection of recombinant tissue plasminogen activator （rt-PA） in the treatment of acute ischemic stroke （AICVD）. Methods A total of 60 patients with AICVD were equally divided into a combination group and an rt-PA group. The rt-PA group was treated with arterial injection of rt-PA only; and the combination group was additionally treated with Solitaire AB stent thrombectomy. The effects, revascularization, prognosis and safety between the two groups were compared. Results The overall response rate （ORR） in the combination group was significantly higher than that in the rt-PA group （P 〈 0.05）; three days and one month after the operation, the revascularization rate in the combination group was higher than that in the rt-PA group （P 〈 0.05）; after the treatment, the national institutes of health stroke scale （NIHSS） scores in the two groups decreased, while glasgow coma scale （GCS） scores increased （P 〈 0.05）, and the improvement in the combination group was greater than that in the rt-PA group （P 〈 0.05）; three months after the operation, the modified Rankin scale （mRS） scores in the combination group were lower than those in the rt-PA group （P 〈 0.05）. After the operation, symptomatic intraeranial hemorrhage, repeffusion injury, incidence of secondary cerebral embolism and mortality showed no significant difference between the two groups （P 〉 0.05）. Conclusion Solitaire AB stent thrombectomy combined with arterial injection of rt-PA has exact effects, good prognosis and high safety in the treatment of AICVD.