不同血管再通方法在急性脑梗塞患者中的临床疗效评价

Clinical Evaluation of Different Recanalization Methods in Patients with Acute Cerebral Infarction

目的比较静脉溶栓、机械取栓及桥接治疗急性脑梗死的临床疗效。方法选取河南省漯河医学高等专科学校第二附属医院神经内科2016年1月—2019年1月收治的急性脑梗死患者78例,根据不同治疗方法分静脉溶栓组30例,机械取栓组25例,静脉溶栓桥接组23例。分别对各组治疗前、治疗后24 h、治疗后14 d美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分及治疗后90 d改良Rankin量表(Modified Rankin Scale,mRS)评分进行比较,评估疗效。结果与治疗前相比,机械取栓组、桥接治疗组治疗后24 h、14 d NIHSS评分明显降低(P<0.05),机械取栓组、桥接治疗组NIHSS评分均低于静脉溶栓组(P<0.05),而机械取栓组和桥接组治疗后各时间点NIHSS评分相近,差异无统计学意义(P>0.05)。桥接组、机械取栓组90 d后mRS评分明显低于静脉溶栓组,差异有统计学意义(P<0.05),桥接组与机械取栓组相比,差异无统计学意义(P>0.05)。结论采用静脉溶栓、机械取栓或桥接治疗,均可使急性脑梗死患者神经功能改善,采用机械取栓、桥接治疗对神经功能改善时间较早,远期预后较好。

Objective To compare the clinical effi cacy of intravenous thrombolysis,mechanical thrombectomy and bridging in the treatment of acute cerebral infarction.Methods From January 2016 to January 2019,78 patients with acute cerebral infarction were selected from the Department of Neurology,the Second Affiliated Hospital of Luohe Medical Higher Vocational School,Henan Province.They were divided into intravenous thrombolysis group(n=30)and mechanical thrombectomy group(n=25)according to diff erent therapeutic methods,venous Thrombolysis Bridging Group(n=23).The National Institutes of health stroke scale(NIHSS)scores before treatment,24 hours after treatment,14 days after treatment and Modifi ed Rankin Scale(mRS)Scores at 90 days after treatment were compared in each group to evaluate the therapeutic eff ect.The patient’s curative eff ect was compared with the analysis of NIHSS within 24 hours in the later period of treatment.Results Compared with before treatment,NIHSS scores of mechanical thrombectomy group and bridging treatment group were signifi cantly lower 24 h and 14 d after treatment(P<0.05).NIHSS scores of mechanical thrombectomy group and bridging treatment group were lower than those of intravenous thrombolysis group(P<0.05),while NIHSS scores of mechanical thrombectomy group and bridging treatment group were similar at each time point after treatment,without statistical signifi cance(P>0.05).After 90 days,mRS score of bridging group and mechanical thrombectomy group was signifi cantly lower than that of intravenous thrombolysis group(P<0.05),but there was no signifi cant diff erence between bridging group and mechanical thrombectomy group(P>0.05).Conclusion Intravenous thrombolysis,mechanical thrombectomy or bridging therapy can improve the neurological function of patients with acute cerebral infarction.Mechanical thrombectomy and bridging therapy can improve the neurological function earlier and have better long-term prognosis.