血管内机械取栓联合动静脉溶栓治疗急性脑梗死疗效观察

Therapeutic effect of intravascular mechanical thrombectomy combined with arteriovenous thrombolysis for acute cerebral infarction

目的探讨血管内机械取栓联合动静脉溶栓与单纯动静脉溶栓治疗急性脑梗死的临床疗效及预后。方法回顾性分析2017年5月至2018年12月该院收治的217例急性脑梗死患者临床资料,将实施血管内机械取栓联合动静脉溶栓治疗的113例患者设为观察组,实施动静脉联合溶栓治疗的104例患者设为对照组。比较两组患者治疗前后美国卫生研究院卒中量表(NIHSS)评分,牛津残障量表(OHS)预后情况和治疗期间并发症。结果治疗前,NIHSS评分组间比较差异无统计学意义(P>0.05),观察组治疗后24 h、7 d、30 d时NIHSS评分均低于对照组(P<0.05)。观察组OHS量表评价致残率为25.66%,明显低于对照组的61.54%,组间差异有统计学意义(χ^2=7.194,P=0.011)。观察组治疗期间并发症发生率为7.96%,明显低于对照组22.12%,组间差异有统计学意义(χ^2=6.385,P=0.017)。结论血管内机械取栓联合动脉溶栓可有效降低急性脑梗死患者神经功能缺损程度、致残率及并发症发生率。

【Objective】To investigate the clinical efficacy and prognosis of intravascular mechanical thrombectomy combined with arteriovenous thrombolysis and simple arteriovenous thrombolysis for acute cerebral infarction.【Methods】The clinical data of 217 patients with acute cerebral infarction admitted to Nanyang Central Hospital from May 2017 to December 2018 were retrospectively analyzed.One hundred and thirteen patients who underwent endovascular mechanical thrombectomy combined with arteriovenous thrombolysis were used as the observation group.One hundred and four patients who underwent arteriovenous thrombolysis were used as the control group.The National Institute of Health Stroke Scale(NIHSS)scores,the Oxford Handicap Scale(OHS)prognosis,and complications during treatment were compared between the two groups.【Results】Before treatment,there was no significant difference between the NIHSS scores(P>0.05).The NIHSS scores of the observation group were lower than those of the control group at 24 h,7 d,and 30 d after treatment(P<0.05).The disability rate of the observation group evaluated by OHS was 25.66%,which was significantly lower than that of the control group(61.54%).The difference between the groups was statistically significant(χ^2=7.194,P=0.011).The incidence of complications during the observation group was 7.96%,which was significantly lower than that of the control group(22.12%).The difference between the two groups was statistically significant(χ^2=6.385,P=0.017).【Conclusion】Intravascular mechanical thrombectomy combined with arterial thrombolysis can effectively reduce the degree of neurological deficit,disability and complication rate in patients with acute cerebral infarction.