奥扎格雷钠联合支架取栓治疗急性重型缺血性脑卒中的有效性评估

Efficacy of sodium ozagrel combined with stent thrombectomy for acute severe ischemic cerebral infarction

目的 :探索奥扎格雷钠联合支架取栓治疗急性重型缺血性脑卒中的安全性及有效性。方法 :选择急性重型血栓性脑卒中患者106例,随机分为对照组和联合治疗组各53例。在常规治疗基础上,对照组给予奥扎格雷钠单药治疗,联合治疗组同时给予奥扎格雷钠联合支架取栓治疗。比较两组患者治疗6个月、12个月的复发率,并使用格拉斯哥昏迷量表(GCS)和美国国立卫生研究院脑卒中量表(NIHSS)评估患者治疗前和治疗30d后神经功能改善情况;采用事件相关电位测试、眼动测试评定患者治疗前和治疗30d后认知功能改变;记录两组治疗后颅内出血、呼吸衰竭、肺部感染发生情况。结果 :联合治疗组患者的6个月和12个月的复发率显著低于对照组。联合治疗组和对照组的NIHSS评分和GCS评分在治疗前无显著统计学差异,而在治疗后,两组的得分具有显著统计学差异。两组患者的NIHSS评分和GCS评分在治疗前后分别具有显著统计学差异。联合治疗组和对照组的潜伏期、波幅、NEF和RSS得分在治疗前无显著统计学差异,而在治疗后,两组的潜伏期、波幅、NEF和RSS得分具有显著统计学差异。两组患者的潜伏期、波幅、NEF和RSS得分在治疗前后分别具有统计学差异。两组患者患者在治疗后肺部感染的发病率具有显著统计学差异,而颅内出血和呼吸衰竭的发生率无显著统计学差异。结论 :与单纯奥扎格雷钠治疗相比,支架取栓联合奥扎格雷钠治疗急性重型血栓性脑卒中可以减少患者复发率和并发症发生率,提升患者神经和认知功能。

Objective To explore the safety and efficacy of sodium ozagrel combined with stent thrombectomy for acute severe ischemic cerebral infarction. Methods A total of 106 patients with acute severe thrombotic stroke were randomly divided into control group and combined treatment group. On the basis of conventional treatment, the control group was given monotherapy with ozagrel sodium, and the combination treatment group was given ozagrel sodium combined with stent thrombectomy.The recurrence rate was compared between the two groups at 12 months, and the Glasgow Coma Scale(GCS) and the National Institutes of Health Stroke Scale(NIHSS) were used to assess neurological improvement before and 30 days after treatment;Potentiometric test and eye movement test were used to assess the cognitive function changes before and after treatment for 30 days. The incidence of intracranial hemorrhage, respiratory failure and lung infection were recorded after treatment. Results The recurrence rate of the 6-month and 12-month patients in the combined treatment group was significantly lower than that in the control group. The NIHSS score and GCS score of the combined treatment group and the control group were not significantly different before treatment, but after treatment, the scores of the two groups were statistically significant. In addition, in the intragroup comparison, the NIHSS score and GCS score of the two groups were significantly different before and after treatment. The latency, amplitude, NEF and RSS scores of the combined treatment group and the control group were not significantly different before treatment, but the latency, amplitude, NEF and RSS scores of the two groups were significantly different after treatment.In addition, in the intra-group comparison, the latency, amplitude, NEF, and RSS scores of the two groups were significantly different before and after treatment. There was a statistically significant difference in the incidence of pulmonary infection between the two groups, but there was no statistically significant difference in the incidence of intracranial hemorrhage and respiratory failure. Conclusion Compared with ozagrel sodium alone, stent thrombectomy combined with ozagrel sodium in the treatment of acute severe thrombotic stroke can reduce the recurrence rate and complications of patients, and improve the neurological and cognitive functions of patients.