rt-PA动脉溶栓联合支架取栓对急性缺血性脑卒中治疗效果及近期预后的影响

Effect of rt-PA Intra-arterial Thrombolysis Combined with Stent Retriever Thrombectomy on the Treatment and Short-term Prognosis of Acute Ischemic Stroke

目的观察重组组织型纤溶酶原激活剂(rt-PA)动脉溶栓联合支架取栓治疗急性缺血性脑卒中的效果及对近期预后的影响。方法选取2017年8月—2018年11月我院收治的急性缺血性脑卒中97例,根据治疗方法的不同分为研究组49例和对照组48例,对照组给予rt-PA动脉溶栓治疗,研究组在对照组基础上联合支架取栓治疗。1个月后比较两组临床疗效、血管再通率,两组治疗前及治疗1个月时美国国立卫生研究院卒中量表(NIH stroke scale,NIHSS)评分、日常生活能力量表(activity of daily living scale,ADL)评分,以及治疗期间不良反应发生情况。结果研究组总有效率及血管再通率均显著高于对照组(P<0.05)。治疗后1个月两组NIHSS评分均显著低于治疗前,且研究组NIHSS评分降低程度显著大于对照组(P<0.05或P<0.01);治疗后1个月两组ADL评分均显著高于治疗前,且研究组ADL评分升高程度显著大于对照组(P<0.05或P<0.01)。两组治疗期间总不良反应发生率比较差异无统计学意义(χ2=0.105,P=0.746)。结论rt-PA动脉溶栓联合支架取栓能有效提高急性缺血性脑卒中患者的临床治疗效果,极大提升血管再通率,改善近期预后,且治疗安全性良好。

Objective To observe the effect of recombinant tissue plasminogen activator(rt-PA)intra-arterial thrombolysis combined with stent retriever thrombectomy in the treatment of acute ischemic stroke(AIS)and its effect on the short-term prognosis.Methods A total of 97 cases of AIS admitted to our hospital from August 2017 to November 2018 were divided into research group(n=49)and control group(n=48)according to different treatment methods.The control group was treated with rt-PA intra-arterial thrombolysis,and the research group was supplemented with stent retriever thrombectomy on the basis of the control group.At one month after treatment,the clinical efficacy and vascular recanalization rate of the two groups were compared.The NIH stroke scale(NIHSS)score and activity of daily living scale(ADL)score before and one month after treatment,as well as the adverse reactions during the treatment were compared.Results The total effective rate and vascular recanalization rate in research group were significantly higher than those in the control group(P<0.05).At one month after treatment,NIHSS scores of the two groups were significantly lower than those before treatment,and the reduction of NIHSS scores of the research group was significantly larger than that of the control group(P<0.05 or P<0.01).ADL scores of the two groups were significantly higher than those before treatment,and the increase of ADL scores of the research group was significantly higher than that of the control group(P<0.05 or P<0.01).There was no significant difference in the incidence of total adverse reactions between the two groups(χ2=0.105,P=0.746).Conclusion rt-PA thrombolysis combined with stent retriever thrombectomy can effectively improve clinical effect of patients with AIS,greatly improve the vascular recanalization rate,and improve the short-term prognosis of patients,with good treatment safety.