血管内介入手术与内科药物保守治疗椎-基底动脉狭窄所致后循环脑梗死的效果比较

Comparison of the effects of endovascular interventional surgery and conservative treatment with medical drugs on posterior circulation cerebral infarction caused by vertebrobasilar artery stenosis

目的比较血管内介入手术与内科药物保守治疗椎-基底动脉狭窄所致后循环脑梗死的效果。方法回顾性分析2018年7月至2022年9月于福建中医药大学附属第二人民医院神经内科住院治疗的39例椎-基底动脉狭窄所致后循环脑梗死患者为研究对象,根据治疗方案不同将其分为血管内介入手术组(20例,血管内介入手术治疗)和内科药物保守治疗组(19例,药物治疗)。比较两组的血液指标、美国国立卫生院卒中量表(NIHSS)评分、预后情况及不良事件发生情况。结果治疗前、后,两组的低密度脂蛋白、高密度脂蛋白、总胆固醇、甘油三酯、肌酐、纤维蛋白原及尿酸水平比较,差异无统计学意义(P>0.05)。治疗14 d后,两组的NIHSS评分均降低,且血管内介入手术组低于内科药物保守治疗组,差异具有统计学意义(P<0.05)。血管内介入手术组的预后良好率为95.00%,高于内科药物保守治疗组的63.16%,差异具有统计学意义(P<0.05)。两组的各项不良事件发生率比较,差异无统计学意义(P>0.05)。结论血管内介入手术治疗椎-基底动脉狭窄所致后循环脑梗死预后良好。

Objective To compare the effects of endovascular interventional surgery and conservative treatment with medical drugs on posterior circulation cerebral infarction caused by vertebrobasilar artery stenosis.Methods A retrospective analysis of 39 patients with posterior circulation cerebral infarction caused by vertebrobasilar artery stenosis who were hospitalized in the neurology department of the Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine from July 2018 to September 2022 was conducted.According to different treatment options,the patients were divided into endovascular interventional surgery group(20 cases,endovascular interventional surgery)and conservative treatment with medical drugs group(19 cases,drug treatment).The blood indexes,the National Institutes of Health Stroke Scale(NIHSS)score,prognosis and incidence of adverse events were compared between the two groups.Results Before and after treatment,there were no significant differences in the levels of low density lipoprotein,high density lipoprotein,total cholesterol,triglyceride,creatinine,fibrinogen and uric acid between the two groups(P>0.05).After 14 d of treatment,the NIHSS score of the two groups decreased,and that in the endovascular interventional surgery group was lower than the conservative treatment with medical drugs group,the difference was statistically significant(P<0.05).The good prognosis rate of the endovascular interventional surgery group was 95.00%,which was higher than 63.16%of the conservative treatment with medical drugs group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Endovascular interventional surgery for posterior circulation cerebral infarction caused by vertebrobasilar artery stenosis has a good prognosis.