摘要
目的探讨局部溶栓联合急诊支架成形开通术对急性颅内动脉闭塞病人闭塞血管再开通率的影响。方法回顾性分析2015年6月至2018年6月郑州大学附属洛阳中心医院收治的140例急性缺血性脑卒中病人临床资料,根据治疗方案分为观察组(n=66)和对照组(n=74),两组均予以急诊支架成形开通术,观察组在此基础上联合局部溶栓(组织型纤溶酶原激活物)治疗。评估两组术前、术后1 d、术后7 d时神经损伤程度[美国国立卫生研究院卒中量表(NIHSS)],比较两组病人闭塞血管再通率和临床疗效,随访3个月评估病人预后状况[改良Rankin量表(mRS)]。结果①术后1 d、术后7 d观察组NIHSS得分(10.94±2.42)分、(8.42±2.76)分,对照组NIHSS得分(14.51±3.16)分、(11.66±3.05)分均低于术前(18.88±4.33)分、(19.95±4.48)分(P<0.05),且随时间变化而降低(P<0.05),观察组各时间点NIHSS得分均低于对照组(P<0.05);②观察组再通率为93.94%(62/66),对照组再通率为82.43%(61/74);观察组闭塞血管再通率高于对照组(χ2=4.330,P=0.037);③术后7 d,观察组治疗总有效率93.94%高于对照组82.43%(P<0.05);④随访3个月后,观察组预后良好率65.15%高于对照组45.95%(P<0.05)。结论局部溶栓联合急诊支架成形开通术能提高闭塞血管再开通率,并有利于改善病人神经功能和预后状况。
Objective To explore the effects of local thrombolysis combined with emergency stenting on the recanalization rate of occlusive vessels in patients with acute intracranial occlusion.Methods The clinical data of 140 patients with acute ischemic stroke admitted in Luoyang Central Hospital Affiliated to Zhengzhou University from June 2015 to June 2018 were retrospectively analyzed.According to the treatment regimens,they were divided into the observation group(n=66)and the control group(n=74).The two groups were treated with emergency stenting,and based on which the observation group was combined with local thrombo lytic therapy(tissue plasminogen activator).The degree of nerve injury[National Institutes of Health Stroke Scale(NIHSS)]was as sessed before surgery,at 1 d after surgery and at 7 d after surgery.The recanalization rate of occlusive vessels and clinical efficacy were compared between the two groups.After 3 months of followed up,the prognosis status[modified Rankin scale(mRS)]was evaluated.Results The NIHSS scores in observation group[(10.94±2.42),(8.42±2.76)]and control group[(14.51±3.16),(11.66±3.05)]at 1 d after surgery and at 7 d after surgery were lower than those before surgery[(18.88±4.33),(19.95±4.48)](P<0.05),and the scores were decreased with time(P<0.05),and the NIHSS score in the observation group was lower than that in the control group at each time point(P<0.05).The recanalization rate of occlusive vessels in observation group was higher than that in control group(93.94%vs.82.43%,P<0.05).The total effective rate of treatment in observation group was higher than that in control group at 7 d after operation(93.94%vs.82.43%,P<0.05).After 3 months of follow up,the good rate of prognosis in ob servation group was higher than that in control group(65.15%vs.45.95%,P<0.05).Conclusion Local thrombolysis combined with emergency stenting can improve the recanalization rate of occlusive vessels and improve the neurological function and progno sis of patients.
作者
冼华玮
XIAN Huawei(Department of Neurosurgery,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang,Henan 471000,China)
出处
《安徽医药》
CAS
2020年第5期1011-1014,共4页
Anhui Medical and Pharmaceutical Journal
