直接机械取栓与桥接治疗急性前循环大血管闭塞性脑卒中的对比研究

A comparative study of direct mechanical thrombectomy and bridging in treatment of acute anterior circulation occlusion stroke

目的探讨直接机械取栓与桥接治疗急性前循环大血管闭塞性脑卒中(AIS-LVO)的临床效果。方法选择2018年5月至2020年2月三门峡市中心医院接诊的80例AIS-LVO患者,按随机数字表法分为两组,各40例。直接取栓组行直接机械取栓治疗,桥接组行桥接治疗。比较两组血管再通、神经功能缺损程度、预后、症状性颅脑出血和出血转化发生情况。结果术后14 d两组美国国立卫生研究院卒中量表(NIHSS)评分均下降,两组NIHSS评分比较,差异无统计学意义(P>0.05);两组血管再通率、预后良好率、症状性颅脑出血发生率相比,差异无统计学意义(P>0.05);直接取栓组出血转化发生率低于桥接组,差异有统计学意义(P<0.05)。结论直接机械取栓与桥接治疗AIS-LVO效果相当,前者能够减少出血转化发生,安全性更高。

【Objective】To investigate the clinical effect of direct mechanical thrombectomy and bridging in the treatment of acute anterior circulation occlusion stroke(AIS-LVO).【Methods】Eighty patients with AIS-LVO admitted in our hospital from May 2018 to February 2020 were randomly divided into two groups,40 cases in each group.Direct mechanical thrombectomy was performed in the direct embolectomy group,while bridging therapy was performed in the bridging group.Vascular recanalization,degree of neurological deficit,prognosis,symptomatic cerebral hemorrhage and hemorrhage transformation were compared between the two groups.【Results】On the 14th day after operation,NIHSS scores of the two groups decreased,but there was no significant difference between the two groups(P>0.05);there was no significant difference in the recanalization rate,good prognosis rate and symptomatic cerebral hemorrhage rate between the two groups(P>0.05);the incidence of bleeding transformation in the direct thrombectomy group was lower than that in the bridging group,with statistical significance(P<0.05).【Conclusion】Direct mechanical embolectomy and bridging treatment of AIS-LVO have the same effect,the former can reduce the occurrence of bleeding transformation,and has higher safety.