静脉溶栓桥接支架取栓治疗颅内大血管急性闭塞患者的效果

Effects of intravenous thrombolytic bridging stent thrombectomy in patients with acute intracranial large vessel occlusion

目的:观察静脉溶栓桥接支架取栓治疗颅内大血管急性闭塞患者的效果。方法:选取2019年2月至2021年12月该院收治的80例颅内大血管急性闭塞患者进行前瞻性研究,以随字数字表法将其分为对照组和观察组各40例。对照组采取支架取栓术治疗,观察组采取静脉溶栓桥接支架取栓术治疗,比较两组血管再通率、血管再通时间、取栓次数、手术前后神经功能缺损[美国国立卫生研究院卒中量表(NIHSS)]评分、预后良好率、手术前后脑血流动力学指标[大脑前动脉(ACA)、大脑后动脉(PCA)血流速度]水平和术后2周并发症发生率。结果:观察组血管再通率为92.50%(37/40),高于对照组的75.00%(30/40),差异有统计学意义(P<0.05);观察组血管再通时间短于对照组,取栓次数少于对照组,差异均有统计学意义(P<0.05);术后24、72 h,两组NIHSS评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组预后良好率为72.50%(29/40),显著高于对照组的45.00%(18/40),差异有统计学意义(P<0.05);术后,两组ACA、PCA血流速度均大于术前,且观察组大于对照组,差异有统计学意义(P<0.05);两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:静脉溶栓桥接支架取栓术治疗颅内大血管急性闭塞患者可提高血管再通率、预后良好率和脑血流速度,缩短血管再通时间,减少取栓次数,降低NIHSS评分,效果优于单纯支架取栓术治疗。

Objective:To observe effects of intravenous thrombolytic bridging stent thrombectomy in patients with acute intracranial large vessel occlusion.Methods:A prospective study was conducted on 80 patients with acute intracranial large vessel occlusion admitted to the hospital from February 2019 to December 2021.They were divided into control group and study group according to the random number table method,40 cases in each.The control group was treated with stent thrombectomy,while the observation group was treated with intravenous thrombolytic bridging arterial stent thrombectomy.The vascular recanalization rate,the vascular recanalization time,the number of thrombectomy,the neurological deficit[National Institutes of Health Stroke scale(NIHSS)]score before and after the surgery,the good prognosis rate,the cerebral hemodynamic index levels[anterior cerebral artery(ACA),posterior cerebral artery(PCA)blood flow velocity]before and after the surgery,and the incidence of complications 2 weeks after the surgery were compared between the two groups.Results:The vascular recanalization rate of the observation group was 92.50%(37/40),which was higher than 75.00%(30/40)of the control group,and the difference was statistically significant(P<0.05).The average recanalization time of the observation group was shorter than that of the control group,the number of thrombectomy was less than that of the control group,and the differences were statistically significant(P<0.05).24 and 72 h after the surgery,the NIHSS scores of the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The good prognosis rate of the observation group was 72.50%(29/40),which was significantly higher than 45.00%(18/40)of the control group,and the difference was statistically significant(P<0.05).After the surgery,the blood flow velocities of ACA and PCA in the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusions:Intravenous thrombolytic bridging stent thrombectomy in the treatment of the patients with acute intracranial large vessel occlusion can improve the recanalization rate,the good prognosis rate and the cerebral hemodynamic index levels,shorten the average vascular recanalization time,reduce the number of thrombectomy and reduce the NIHSS scores.Moreover,it is superior to single stent thrombectomy.