机械取栓与静脉溶栓治疗急性脑梗死临床分析

Clinical analysis of mechanical thrombectomy and intravenous thrombolysis for acute cerebral infarction

目的分析机械取栓、静脉溶栓及保守治疗急性脑梗死的临床效果、安全性及预后。方法选择2016-06—2018-03安阳市人民医院治疗的101例急性脑梗死患者为研究对象,根据不同治疗方案分为A组(机械取栓组,35例)、B组(静脉溶栓组,34例)及C组(保守治疗组,32例)。使用美国国立卫生研究院卒中量表(NIHSS)评分及90d改良Rankin量表(mRS),比较各组治疗前、治疗后即刻、治疗后24h、治疗后1周和2周的有效性及安全性。结果治疗后2周,3组总体NIHSS评分显著下降(P<0.05),A、B组NIHSS评分明显低于C组,A组明显低于B组,差异均有统计学意义(P<0.05)。治疗后1周,3组颅内出血率、消化道出血率、病死率差异无统计学意义(P>0.05)。治疗后3个月,3组mRS≤2分者所占比例差异有统计学意义(P<0.05)。结论机械取栓与静脉溶栓对大动脉急性脑梗死均有良好的临床疗效,且机械取栓较静脉溶栓安全性更高,远期预后良好。

Objective To analyze the clinical efficacy,safety and prognosis of mechanical thrombectomy,intravenous thrombolysis and conservative treatment of acute cerebral infarction.Methods 101 patients with acute cerebral infarction treated by Anyang Peoples Hospital from 2016-06 to 2018-03 were selected as subjects.They were divided into group A(mechanical thrombectomy group,35 cases)and group B(venous thrombolysis according to different treatment options,34 patients)and group C(conservative treatment group,32 patients).Using the National Institutes of Health Stroke Scale(NIHSS)score and the 90-day modified Rankin Scale(mRS),Effectiveness and safetyof each group were compared before treatment,immediately after treatment,24hours after treatment,1 week and2 weeks after treatment.Results At 2 weeks after treatment,the overall NIHSS scores of the three groups decreased significantly(P<0.05).The NIHSS scores of group A and group B were significantly lower than group C,and those of group A were significantly lower than those of group B(P<0.05).One week after treatment,there was no significant difference in intracranial hemorrhage rate,gastrointestinal bleeding rate and mortality between the three groups(P>0.05).At 3 months after treatment,there was significant difference in the proportion of the three groups with mRS≤2 points(P<0.05).Conclusion Mechanical thrombectomy and intravenous thrombolysis have a good clinical effect on acute cerebral infarction of aorta,and mechanical thrombectomy is safer than intravenous thrombolysis,and the long-term prognosis is good.