直接取栓与桥接治疗对发病4.5h内急性后循环大血管闭塞性脑卒中患者的疗效及预后的影响

Effect of Direct Thrombolysis and Bridging Treatment on the Efficacy and Prognosis of Acute Posterior Circulation Large Vessel Occlusion Stroke Patients within 4.5 h of Onset

目的:分析直接取栓与桥接治疗对发病4.5 h内急性后循环大血管闭塞性脑卒中患者的治疗效果及预后的影响。方法:回顾性分析2019年11月-2021年11月于武穴市中医医院进行治疗的80例发病4.5 h内急性后循环大血管闭塞性脑卒中患者的临床资料,按照治疗方式的不同将患者分为桥接治疗组、直接取栓组,每组40例。比较两组血管再通情况、神经功能缺损评分(NIHSS)、格拉斯哥昏迷指数(GCS)评分、预后和并发症发生情况。结果:治疗后,直接取拴组血管再通情况优于桥接治疗组,差异有统计学意义(P<0.05)。治疗前,两组NIHSS、GCS评分比较,差异均无统计学意义(P>0.05);治疗后,直接取栓组NIHSS评分低于桥接治疗组,GCS评分高于桥接治疗组,差异均有统计学意义(P<0.05)。直接取栓组预后良好率高于桥接治疗组,差异有统计学意义(P<0.05)。桥接治疗组并发症发生率高于直接取栓组,差异有统计学意义(P<0.05)。结论:两种治疗手段均对患者有着一定的治疗效果,但直接取栓治疗效果要优于桥接治疗,有着较好的临床治疗价值,值得临床推广使用。

Objective:To analyze the effect of direct thrombolysis and bridging treatment on the efficacy and prognosis of acute posterior circulation large vessel occlusion stroke patients within 4.5 h of onset.Method:The clinical data of 80 patients with acute posterior circulation large vessel occlusion stroke within 4.5 h of onset who were treated in Wuxue Hospital of Traditional Chinese Medicine from November 2019 to November 2021 were retrospective analyzed,according to the different treatment methods,the patients were divided into bridging treatment group and direct thrombolysis group,with 40 cases in each group.Vascular recanalization,neurological deficit score(NIHSS),Glasgow coma index(GCS)score,prognosis and complications were compared between two groups.Result:After treatment,vascular recanalization in the direct thrombolysis group was better than that in the bridging treatment group,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in NIHSS and GCS scores between two groups(P>0.05);after treatment,NIHSS score in the direct thrombolysis group was lower than that in the bridging treatment group,and GCS score in the direct thrombolysis group was higher than that in the the bridging treatment group,the differences were statistically significant(P<0.05).The rate of good prognosis in direct thrombolysis group was higher than that in the bridging treatment group,the difference was statistically significant(P<0.05).The incidence of complications in the bridging treatment group was higher than that in direct thrombolysis group,the difference was statistically significant(P<0.05).Conclusion:Both treatment methods have a certain therapeutic effect on patients,but the effect of direct thrombolysis is better than that of bridging treatment,it has good clinical therapeutic value and worthy of clinical promotion.