伴有大动脉狭窄的脑梗死行支架取栓和静脉溶栓的对比研究

A Comparative Study of Stent Thrombectomy and Intravenous Thrombolysis for Cerebral Infarction with Large Artery Stenosis

目的脑梗死合并大动脉狭窄患者采用静脉溶栓或者是采用支架取栓,观察两组治疗手段的效果,以及治疗后的安全性。方法随机抽选2017年5月—2019年5月该院收治的脑梗死合并大动脉狭窄患者62例,回顾资料分析其治疗效果并且根据分析需要分成两组,其中31例采用支架取栓治疗,分成支架取栓组,31例采用静脉溶栓治疗,分成静脉溶栓组。对两组患者的MRS评分、NIHSS评分、血管再通率情况分析,以及两组患采用不同治疗方法后脑出血和死亡情况。结果支架取栓组MRS评分和NIHSS评分率都低于静脉溶栓组但,NIHSS评分改善率差异无统计学意义(P>0.05);支架取栓组血通率为87.10%高于静脉溶栓组54.39%(χ2=7.828,P<0.05)。患者治疗后90 d内跟踪观察,两组患者发生脑出血例数相同,并且都发生两起死亡案例。结论脑梗死合并大动脉狭窄患者采用静脉溶栓方法治疗后,MRS评分和NIHSS评分好;脑梗死合并大动脉狭窄患者采用支架取栓治疗后血管再通率高。

Objective Patients with cerebral infarction and aortic stenosis were treated with intravenous thrombolysis or thrombus removal with a stent to observe the effects of the two treatments and the safety after treatment.Methods 62 patients with cerebral infarction and aortic stenosis admitted to the hospital from May 2017 to May 2019 were randomly selected.The data were reviewed to analyze the treatment effect and divided into two groups according to the analysis needs.31 of them were treated with stent thrombectomy and divided into two groups In the stent thrombolysis group,31 cases were treated with intravenous thrombolysis and divided into intravenous thrombolysis group.Analysis of the MRS score,NIHSS score,and vascular recanalization rate of the two groups of patients,as well as the cerebral hemorrhage and death of the two groups of patients after using different treatment methods.Results The MRS score and NIHSS score rate of the stent thrombolysis group were lower than those of the intravenous thrombolysis group.howerver,the improvement rate of NIHSS rate was not statistically significant(P>0.05);the blood circulation rate of the stent thrombolysis group was 87.10%higher that of the intravenous thrombolysis group 54.39%(χ2=7.828,P<0.05).The patients were followed up within 90 d after treatment.The two groups of patients had the same number of cerebral hemorrhages,and two deaths occurred in both.Conclusion The MRS score and NIHSS score of patients with cerebral infarction combined with aortic stenosis treated by intravenous thrombolysis are good;patients with cerebral infarction combined with aortic stenosis have a high rate of vessel recanalization after stent thrombectomy.