超选择性动脉溶栓联合支架取栓在治疗大动脉脑梗死患者中的应用

Application of superselective intra-arterial thrombolysis combined with stent thrombectomy in the treatment of patients with cerebral infarction of the great arteries and its effect on NIHSS score

目的探讨超选择性动脉溶栓联合支架取栓在治疗大动脉脑梗死患者中的应用及对患者美国国立卫生研究院卒中量表(NIHSS)评分的影响。方法选取唐山市协和医院2016年1月~2018年12月收治的大动脉脑梗死患者78例,根据手术方式分为对照组和联合组,各39例。其中对照组患者接受超选择性动脉溶栓术治疗,联合组患者接受超选择性动脉溶栓联合支架取栓术治疗。比较分析两组患者治疗后的临床疗效和安全性及治疗前后的NIHSS评分、脑血流动力学的变化。结果联合组的临床总有效率为92.31%,明显高于对照组的71.79%,差异有统计学意义(P <0.05)。联合组治疗过程中的并发症发生率为10.26%,明显低于对照组的28.21%,差异有统计学意义(P <0.05)。治疗1周后,联合组NIHSS评分明显低于对照组,差异有统计学意义(P <0.05)。联合组治疗后Q和V水平均上升,且联合组明显高于对照组,R和Zc水平均下降,且联合组明显低于对照组,差异有统计学意义(P <0.05)。结论应用超选择性动脉溶栓联合支架取栓术对大动脉脑梗死患者进行治疗,疗效显著,明显降低并发症发生率,提高NIHSS评分,改善患者脑血流动力学,值得在临床上大力推广。

Objective To explore the application of superselective intra-arterial thrombolysis combined with stent embolization in the treatment of patients with cerebral infarction of the great arteries and the effect on NIHSS score.Methods Seventy-eight patients with cerebral infarction of the great arteries were divided into control group and combined group,39 cases each.The control group received superselective intra-arterial thrombolysis and the combined group received superselective intra-arterial thrombolysis combined with stenting.The clinical efficacy and safety,NIHSS score and cerebral hemodynamic changes before and after treatment were compared and analyzed between the two groups.Results The total clinical effective rate of the combined group was 92.31%,which was significantly higher than that of the control group(P<0.05).The incidence of complications was 10.26%in the combined group,which was significantly lower than 28.21%in the control group(P<0.05).The NIHSS score of the combined group was significantly lower than that of the control group one week after treatment(P<0.05).After treatment,the Q and V levels in the combined group increased,and the levels of R and Zc in the combined group were significantly higher than those in the control group,and the levels of R and Zc in the combined group were significantly lower than those in the control group(P<0.05).Conclusion Superselective intra-arterial thrombolysis combined with stent thrombectomy for the treatment of patients with cerebral infarction of the great arteries has a significant effect,which can significantly reduce the incidence of complications,improve the NIHSS score and improve the cerebral hemodynamics of patients.It is worthy of vigorous promotion in clinical practice.