阿替普酶动脉溶栓联合血管内支架成形术治疗发病时间6 h内急性脑梗死的效果

Effect of alteplase arterial thrombolysis combined with endovascular stenting on acute cerebral infarction within 6 hours of onset

目的分析阿替普酶(rt-PA)动脉溶栓联合血管内支架成形术治疗发病时间6 h内急性脑梗死患者的效果及神经功能。方法选取2018年11月至2021年4月河南大学淮河医院收治的84例发病时间6 h内的急性脑梗死患者的临床资料。根据随机数字表法分为对照组和试验组,每组42例。对照组予以rt-PA动脉溶栓,试验组在对照组的基础上联用血管内支架成形术。比较两组疗效、血管再通情况及治疗前、治疗后3个月美国国立卫生研究院卒中量表(NIHSS)。结果治疗后,试验组治疗总有效率(95.24%,40/42)较对照组(73.81%,31/42)高,差异有统计学意义(χ^(2)=7.372,P<0.05)。治疗前,两组NIHSS评分比较,差异未见统计学意义(P>0.05);治疗3个月后,试验组NIHSS评分较对照组低(P<0.05)。试验组血管完全再通率(92.86%,39/42)较对照组(76.19%,32/42)高,差异有统计学意义(P<0.05)。结论rt-PA动脉溶栓联合血管内支架成形术治疗发病时间6 h内急性脑梗死患者,可提高疗效与血管再通率,并促进神经功能恢复。

Objective To analyze the effect and neurological function of arterially thrombolytic therapy with alteplase(rt-PA)combined with intravascular stenting in the treatment of patients with acute cerebral infarction within 6 hours of onset.Methods Eighty-four patients with acute cerebral infarction within 6 hours of onset in Huaihe Hospital of Henan University from November 2018 to April 2021 were selected.According to the random number table method,they were divided into control group and experimental group,with 42 cases in each group.The control group was treated with rt-PA arterial thrombolysis,and the experimental group was combined with intravascular stenting on the basis of the control group.The efficacy,recanalization and NIHSS before and 3 months after treatment were compared between the two groups.Results After treatment,the total effective rate of the experimental group(95.24%,40/42)was higher than that of the control group(73.81%,31/42)(χ^(2)=7.372,P<0.05).Before treatment,there was no significant difference in NIHSS score between the two groups(P>0.05).After 3 months of treatment,the NIHSS score of the experimental group was lower than that of the control group(P<0.05).The complete recanalization rate of blood vessels in the experimental group(92.86%,39/42)was significantly higher than that in the control group(76.19%,32/42)(P<0.05).Conclusions RT-PA arterial thrombolysis combined with intravascular stenting in the treatment of patients with acute cerebral infarction within 6 hours of onset can improve the curative effect and vascular recanalization rate,and promote the recovery of neurological function.