颅内血管重度狭窄及闭塞患者MDT介入治疗与基础药物治疗临床对比观察

Clinical comparison of MDT interventional therapy and basic drug therapy in patients with severe intracranial stenosis and occlusion

目的探讨颅内血管重度狭窄及闭塞患者多学科诊疗(multi-disciplinary treatment,MDT)与基础药物治疗的临床效果。方法选取2019年1月至2021年7月于萍乡市人民医院治疗的80例颅内血管重度狭窄及闭塞患者,按随机数字表法分为对照组和观察组,每组各40例。对照组采用基础药物治疗,观察组在对照组基础上采用MDT评估后血管内介入治疗。比较观察组治疗前后病变动脉狭窄程度及两组的预后、卒中复发率及不良反应。结果治疗后90d观察组的病变动脉狭窄程度为(13.98±2.11)%,低于治疗前的(81.98±5.02)%,差异有统计学意义(P<0.05);治疗后90d、180d、1年时,观察组的改良Rankin量表(modifiedRankin scale,MRS)评分为(1.79±0.50)分、(1.62±0.42)分、(1.48±0.53)分,均低于对照组的(2.04±0.46)分、(2.14±0.51)分、(2.21±0.57)分,差异有统计学意义(P<0.05);观察组卒中复发率低于对照组,但差异无统计学意义(P>0.05)。结论MDT介入治疗颅内血管重度狭窄及闭塞可扩张狭窄血管,降低病变动脉狭窄程度,改善患者预后,且卒中复发率低,临床应用安全性高。

Objective To explore the clinical efficacy of multi-disciplinary treatment(MDT)intervention therapy and basic drug therapy in patients with severe intracranial vascular stenosis and occlusion.Methods Totally 80 patients with severe intracranial vascular stenosis and occlusion who were treated in Pingxiang People’s Hospital from January 2019 to July 2021 were selected and divided into control group and observation group according to random number table,40 patients in each group.The control group received basic drug therapy,while the observation group received intravascular intervention therapy after MDT evaluation on the basis of the control group.Compare the degree of arterial stenosis before and after treatment in the observation group,as well as the prognosis,stroke recurrence rate,and adverse reactions between the two groups.Results At 90 days after treatment,the degree of arterial stenosis in the observation group was(13.98±2.11)%,lower than(81.98±5.02)%before treatment,with a statistically significant difference(P<0.05);At 90 days,180 days,and 1 year after treatment,the modified Rankin scale(MRS)scores of the observation group were(1.79±0.50),(1.62±0.42),and(1.48±0.53),all lower than those of the control group(2.04±0.46),(2.14±0.51),and(2.21±0.57),with statistically significant differences(P<0.05);The recurrence rate of stroke in the observation group was lower than that in the control group,but there was no statistically significant difference between the two groups(P>0.05).Conclusion MDT intervention therapy for severe intracranial vascular stenosis and occlusion can dilate the narrowed vessels,reduce the degree of arterial stenosis,improve patient prognosis,and have a low recurrence rate of stroke,with high clinical application safety.