机械取栓联合血管介入溶栓治疗急性脑梗死患者的效果

Effects of vascular mechanical thrombectomy combined with interventional thrombolysis on patients with acute ischemic cerebral infarction

目的:观察机械取栓联合血管介入溶栓治疗急性脑梗死患者的效果。方法:选取2020年3月至2022年3月佳木斯市中心医院收治的60例急性脑梗死患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各30例。对照组实施血管介入溶栓治疗,观察组实施机械取栓联合血管介入溶栓治疗,比较两组临床疗效、脑动脉内径及血流速度、即刻mTICI血流分级及不良事件发生率。结果:观察组治疗总有效率为96.67%,高于对照组的73.33%,差异有统计学意义(P<0.05);治疗后,观察组颈总动脉、颈内动脉与椎动脉内径与血流速度均大于对照组,差异有统计学意义(P<0.05);观察组mTICI血流分级优于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:机械取栓联合血管介入溶栓治疗急性脑梗死患者,可提高临床疗效,改善患者脑血管血流状态,扩大血流灌注区域,其效果优于单纯血管介入溶栓治疗。

Objective:To observe effects of vascular mechanical thrombectomy combined with interventional thrombolysis in treatment of patients with acute ischemic cerebral infarction.Methods:A prospective study was conducted on 60 patients with acute ischemic cerebral infarction admitted to this hospital from March 2020 to March 2022.They were divided into control group and observation group according to the random number table method,30 cases in each.The control group was treated with interventional thrombolysis,while the observation group was treated with vascular mechanical thrombectomy combined with interventional thrombolysis.The clinical efficacy,the inner diameter of cerebral artery and the blood flow velocity,the immediate mTICI blood flow grading levels,and the incidence of adverse events were compared between the two groups.Results:The total effective rate of treatment in the observation group was 96.67%,which was significantly higher than 73.33%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the inner diameter and the blood flow velocity levels of common carotid artery,internal carotid artery and vertebral artery in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,there was no significant difference in the proportion of grade 1,grade 2a and grade 2b between the two groups(P>0.05).The mTICI blood flow grading in the observation group was better than that in the control group,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Vascular mechanical thrombectomy combined with interventional thrombolysis in the treatment of the patients with acute ischemic cerebral infarction can improve the clinical efficacy,improve the cerebral blood flow status,and expand the blood perfusion area.Moreover,it is superior to interventional thrombolysis.