选择性动脉溶栓并动脉支架血管成形术与静脉溶栓在超早期急性脑梗死患者治疗中的应用比较

Application comparison of selective arterial thrombolysis combined with arterial stent angioplasty and intravenous thrombolysis in the treatment of patients with ultra-early acute cerebral infarction

目的探讨于超早期急性脑梗死患者治疗中实施选择性动脉溶栓并动脉支架血管成形术与静脉溶栓的临床应用效果。方法选取2019年10月~2020年8月于吉安中西医结合医院就诊的60例早期急性脑梗死患者作为研究对象,采用数据奇偶排列方式将其分为试验组和对照组,每组各30例。对照组患者采用静脉溶栓治疗,试验组患者采用选择性动脉溶栓并动脉支架血管成形术,比较两组患者的凝血指标、治疗总有效率以及美国国立卫生研究院卒中量表(NIHSS)评分。结果治疗后6 h、3 d、7 d,试验组患者的凝血酶时间(TT)、凝血酶原时间(PT)长于对照组,差异有统计学意义(P<0.05);治疗后6 h、3 d、7 d,试验组纤维蛋白原(FIB)低于对照组,差异有统计学意义(P<0.05)。试验组患者的治疗总有效率与治疗后7 d的NIHSS评分高于对照组,差异有统计学意义(P<0.05)。结论于超早期急性脑梗死患者治疗中实施选择性动脉溶栓并动脉支架血管成形术治疗方式,有利于优化患者治疗效果,提高患者的治疗有效性,具有临床推广价值。

Objective To explore the clinical application effect of selective arterial thrombolysis combined with arterial stent angioplasty and intravenous thrombolysis in the treatment of patients with ultra-early acute cerebral infarction.Methods A total of 60 patients with early acute cerebral infarction who admitted to Ji′an Intergration of Traditional Chinese and Western Medicine Hospital from October 2019 to August 2020 were selected as the research objective.They were divided into the experimental group and the control group using the data parity arrangement method,with 30 cases in each group.Patients in the control group were treated with intravenous thrombolysis,and patients in the experimental group were treated with selective arterial thrombolysis and arterial stent angioplasty.Coagulation indexes,total response rate and National Institutes of Health stroke scale(NIHSS)scores were compared between the two groups.Results After 6 h,3,7 d treatment,the thrombin time(TT)and prothrombin time(PT)in experimental group were longer than those in control group,and the differences were statistically significant(P<0.05),after 6 h,3,7 d,the fibrinogen(FIB)in the experimental group were lower than those of the control group,and the differences were statistically significant(P<0.05).The total effective rate and NIHSS score after 7 d of treatment in experimental group were higher than those in control group,and the differences were statistically significant(P<0.05).Conclusion The implementation of selective arterial thrombolysis and arterial stent angioplasty in the treatment of patients with ultra-early acute cerebral infarction is beneficial to the optimization of the treatment effect,and the treatment effectiveness of the patient is improved,which has clinical promotion value.