桥接支架治疗对急性脑梗死患者应用效果及神经功能影响

Application effect of bridging stent therapy in patients with acute cerebral infarction and its influence on neurological function

目的研究和探讨桥接支架治疗对急性脑梗死患者应用效果及神经功能影响。方法选取本院于2018年1月-2022年3月期间收治急性脑梗死患者80例,按照交叉双盲法随机分为对照(40例)、观察(40例)两组,对照组患者实施直接血管内支架取栓治疗,观察组患者实施阿替普酶静脉溶栓桥接支架取栓治疗。以美国国立卫生研究院卒中量表(NIHSS)为基础,评定并对比两组治疗前及治疗后1 d、10 d、20 d、30 d等不同时间段NIHSS评分。根据神经特异性烯醇化酶(NSE)、睫状神经营养因子(CNTF)、脑源性神经营养因子(BDNF)等指标,对比两组治疗前后神经功能水平。以改良Rankin量表为基础,评定并对比两组治疗后1 d、10 d、20 d、30 d等不同时间段Rankin评分。结果两组治疗前及治疗后1 d NIHSS评分无差异(P>0.05),治疗后10 d、20 d、30 d观察组NIHSS评分均低于对照组,组间有差异(P<0.05)。治疗前两组NSE等神经功能无差异(P>0.05),治疗后观察组NSE等神经功能水平均优于对照组,组间有差异(P<0.05)。两组治疗后1 d Rankin评分无差异(P>0.05),治疗后10 d、20 d、30 d观察组Rankin评分均低于对照组,组间有差异(P<0.05)。结论为进一步改善临床效果,本次研究对急性脑梗死患者实施阿替普酶静脉溶栓桥接支架取栓治疗方案优于直接血管内取栓治疗,可有效改善患者神经功能及预后,同时逆转脑神经损伤,值得推广。

Objective To study and explore the effect of bridging stents therapy on neurological function in patients with acute cerebral infarction.Methods 80 patients with acute cerebral infarction admitted in our hospital from January 2018 to March 2022 were selected and randomly divided into control group(40 cases)and observation group(40 cases)according to the cross double-blind method.The control group was treated with tent thrombectomy,and the observation group received bridging stent thrombectomy.Based on the National Institutes of Health Stroke Scale(NIHSS),the NIHSS scores of the two groups were evaluated and compared before treatment and 1 day,10 days,20 days,30 days after treatment.Neuron specific enolase(NSE),ciliary neurotrophic factor(CNTF),brainderived neurotrophic factor(BDNF)were used to compare the neurological function of the two groups before and after treatment.Based on the modified Rankin scale,the Rankin scores of the two groups were evaluated and compared at day 1,day 10,day 20 and day 30 after treatment.Results There was no difference in NIHSS score between the two groups before treatment and 1 day after treatment(P>0.05).NIHSS scores in the observation group at 10 days,20 days and 30 days after treatment were lower than those in the control group(P<0.05).There was no difference in NSE and other neurological functions between the two groups before treatment(P>0.05).After treatment,NSE and other neurological functions in the observation group were better than those in the control group,and there was a difference between the two groups(P<0.05).There was no difference in Rankin scores between the two groups on the 1st day after treatment(P>0.05),and the Rankin scores in the observation group at 10,20 and 30 days after treatment were lower than those in the control group,with differences between the two groups(P<0.05).Conclusion In order to further improve the clinical effect,the implementation of alteplase intravenous thrombolysis bridging stent thrombectomy in patients with acute cerebral infarction in this study is superior to direct intravascular thrombectomy,which can effectively improve the neurological function and prognosis of patients,and reverse the brain nerve injury at the same time,and it is worthy of promotion.