Solitaire支架机械取栓联合阿替普酶动脉溶栓治疗急性脑梗死的疗效

Efficacy of Solitaire Stent Mechanical Thrombectomy Combined with Arterial Thrombolysis with Alteplase in the Treatment of Acute Cerebral Infarction

目的:探究Solitaire支架机械取栓联合阿替普酶动脉溶栓治疗急性脑梗死的疗效。方法:选择2017年12月至2021年6月期间佳木斯市中心医院收治的120例急性脑梗死患者,其中71例行静脉溶栓治疗纳入静脉组,49例行Solitaire支架机械取栓联合阿替普酶动脉溶栓治疗纳入动脉组。统计动脉组患者治疗后血管再通情况,比较两组患者美国国立卫生研究院脑卒中量表(NIHSS)及改良Rankin量表(mRS)评分、治疗效果及安全性。结果:动脉组总有效率为95.92%,高于静脉组80.28%,差异具有统计学意义(P<0.05);动脉组治疗后各时段NIHSS评分均低于静脉组,差异具有统计学意义(P<0.05);动脉组治疗3、6个月后的mRS评分均低于静脉组,差异具有统计学意义(P<0.05);动脉组出血发生率为6.12%,静脉组为12.68%,两组比较差异无统计学意义(P>0.05)。结论:Solitaire支架机械取栓联合阿替普酶动脉溶栓治疗具有较高的血管再通率,可改善急性脑梗死患者术后神经功能缺损症状。

Objective To investigate the efficacy of Solitaire stent mechanical thrombectomy combined with arterial thrombolysis with alteplase in the treatment of acute cerebral infarction.Methods A total of 120 patients with acute cerebral infarction who were admitted to Jiamusi Central Hospital from December 2017 to June 2021 were selected.Among them,71 patients who underwent intravenous thrombolysis were defined as the venous group,and 49 patients who underwent Solitaire stent mechanical thrombectomy combined with alteplase arterial thrombolysis were defined as the arterial group.The vascular recanalization of patients in the arterial group after treatment was analyzed,and the scores of National Institutes of Health stroke scale(NIHSS)and modified Rankin scale(mRS),therapeutic efficacy and safety were compared between the two groups.Results The total effective rate of the arterial group was 95.92%,which was higher than 80.28%of the venous group,and the difference was statistically significant(P<0.05).The NIHSS score of the arterial group was lower than that of the venous group at all time after treatment,and the difference was statistically significant(P<0.05).mRS scores in the arterial group were lower than those in the venous group after 3 and 6 months of treatment,and the differences were statistically significant(P<0.05).The incidence of bleeding was 6.12%in the arterial group and 12.68%in the venous group,and there was no statistical significance between the two groups(P>0.05).Conclusion Solitaire stent mechanical thrombectomy combined with arterial thrombolysis with alteplase can achieve a relatively high vascular recanalization rate and improve postoperative neurological impairment in patients with acute cerebral infarction.