机械取栓联合动脉溶栓对缺血性脑卒中患者的疗效及神经功能的影响

Effects of Mechanical Thrombus Removal Combined with Arterial Thrombolysis on Patients with Ischemic Cerebrovascular Disease And Its Influence on Nerve Function

目的探讨机械取栓联合动脉溶栓对缺血性脑卒中患者的疗效及神经功能的影响。方法选取2016年3月至2021年4月于阳江市人民医院治疗的缺血性脑卒中患者56例作为研究对象,按治疗方法不同分为观察组与对照组,各28例。观察组采用机械取栓联合动脉溶栓治疗,对照组采用静脉溶栓治疗。治疗后3周采用美国国立卫生研究院卒中量表(NIHSS)对两组患者疗效进行评估,并比较两组患者治疗前及治疗后24 h、3 d、3周的NIHSS评分,比较治疗后两组患者血管再通情况和预后情况。结果观察组治疗有效率(92.86%)高于对照组(71.43%)(P<0.05)。治疗后24 h、3 d、3周两组患者NIHSS评分较治疗前降低,且随着治疗时间的推移NIHSS评分逐渐降低,差异有统计学意义(P<0.05);且观察组治疗后24 h、3 d、3周NIHSS评分与对照组相同时间比较降低,差异有统计学意义(P<0.05)。治疗3周后,观察组血管再通率(89.29%)高于对照组(71.43%)(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05),观察组复发率和死亡率低于对照组,但差异无统计学意义(P>0.05)。结论机械取栓联合动脉溶栓治疗缺血性脑卒中可提高临床效果,促进患者神经功能恢复。

Objective To investigate the effects of mechanical thrombus removal combined with arterial thrombolysis in the treatment of ischemic cerebrovascular disease and its influence on nerve function. Methods A total of 56 patients with ischemic stroke treated in Yangjiang People’s Hospital from March 2016 to April 2021 were selected as the research objects, and were divided into an observation group and a control group according to different treatment methods, with 28 patients in each group. The observation group was treated with mechanical thrombectomy combined with arterial thrombolysis, and the control group was treated with intravenous thrombolysis. National Institutes of Health Stroke Scale(NIHSS) was used to evaluate the efficacy of the two groups 3 weeks after treatment, and NIHSS scores were compared between the two groups before treatment and 24 h, 3 d and 3 weeks after treatment, and vascular recanalization and prognosis were compared between the two groups after treatment. Results The effective rate of observation group(92.86%) was higher than that of control group(71.43%)(P<0.05). NIHSS scores of the two groups were lower than before 24 h, 3 d and 3 weeks after treatment, and gradually decreased with the passage of treatment time, with statistical significance(P<0.05). The NIHSS score of the observation group was lower than that of the control group at 24 h, 3 d and 3 weeks after treatment,and the difference was statistically significant(P<0.05). After 3 weeks of treatment, the vascular recanalization rate in the observation group(89.29%) was higher than that in the control group(71.43%)(P<0.05). There was no statistical significance in the incidence of adverse reactions between 2 groups(P>0.05), and the recurrence rate and mortality rate in observation group were lower than those in control group, but the difference was not statistically significant(P>0.05). Conclusion Mechanical thrombectomy combined with arterial thrombolysis in the treatment of ischemic stroke can improve the clinical effect and promote the recovery of nerve function.