溶栓+Solitaire AB支架取栓治疗前循环急性脑梗死的有效性及预后观察
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摘要
目的探讨溶栓+Solitaire AB支架取栓治疗(桥接治疗)前循环急性脑梗死的有效性及预后观察。方法选取2014年1月—2018年12月期间180例在中国科学院大学宁波华美医院神经外科就诊的前循环急性脑梗死患者,以随机数字表法分组,对照组90例,以常规rt-PA静脉溶栓治疗;观察组90例,以常规rt-PA静脉溶栓治疗+Solitaire AB支架取栓治疗,对比两组患者血管再通情况、神经功能缺损及日常生活能力变化情况等。结果观察组患者血管再通率为90.0%,对照组为71.1%,观察组明显高于对照组(χ~2=10.23,P=0.001);治疗后,观察组NIHSS评分及BI评分分别为(4.3±0.5)分、(72.7±5.9)分;分别优于对照组的(7.6±0.6)分、(64.8±4.2)分,观察组均优于对照组(t=40.084、10.348,P=0.000、0.000)。结论桥接治疗在提高前循环急性脑梗死患者治疗效果、改善患者预后方面可发挥积极作用,值得推广应用。
Objective To investigate the efficacy and prognosis of thrombolysis plus Solitaire AB stent thrombectomy in the treatment of anterior circulation acute cerebral infarction(ACI). Methods A total of 180 patients with anterior circulation acute cerebral infarction who underwent neurosurgery at the Ningbo Huamei Hospital of the Chinese Academy of Sciences from January 2014 to December2018 were enrolled in a randomized digital table. A total of 90 patients in the control group were treated with conventional rt-PA intravenous thrombolysis; and 90 patients in the observation group were treated with conventional rt-PA intravenous thrombolysis +Solitaire AB stent thrombectomy. And the revascularization, neurological deficit and changes in daily living ability were compared between the two groups. Results The recanalization rate of the observation group was 90.0%, which was significantly higher than that of the control group 71.1%(χ~2=10.23, P=0.001). After treatment, the NIHSS score and BI score of the observation group were(4.3±0.5)points,(72.7±5.9)points, which were better than those of the control group(7.6±0.6)points and(64.8±4.2)points(t=40.084, 10.348, P=0.0000.000). Conclusion Bridging therapy can play an active role in improving the therapeutic effect and prognosis of patients with acute cerebral infarction in anterior circulation, and it is worth popularizing and applying.
Objective To investigate the efficacy and prognosis of thrombolysis plus Solitaire AB stent thrombectomy in the treatment of anterior circulation acute cerebral infarction(ACI). Methods A total of 180 patients with anterior circulation acute cerebral infarction who underwent neurosurgery at the Ningbo Huamei Hospital of the Chinese Academy of Sciences from January 2014 to December2018 were enrolled in a randomized digital table. A total of 90 patients in the control group were treated with conventional rt-PA intravenous thrombolysis; and 90 patients in the observation group were treated with conventional rt-PA intravenous thrombolysis +Solitaire AB stent thrombectomy. And the revascularization, neurological deficit and changes in daily living ability were compared between the two groups. Results The recanalization rate of the observation group was 90.0%, which was significantly higher than that of the control group 71.1%(χ~2=10.23, P=0.001). After treatment, the NIHSS score and BI score of the observation group were(4.3±0.5)points,(72.7±5.9)points, which were better than those of the control group(7.6±0.6)points and(64.8±4.2)points(t=40.084, 10.348, P=0.0000.000). Conclusion Bridging therapy can play an active role in improving the therapeutic effect and prognosis of patients with acute cerebral infarction in anterior circulation, and it is worth popularizing and applying.
引文
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[5]张继红,田开语,李雪松,等.MMSE量表联合Barthel指数在老年脑卒中患者认知障碍评价中的应用[J].中国伤残医学,2012,20(5):30-32.
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[8]张正祥,叶民,周宁,等.SolitaireAB支架取栓治疗在急性脑动脉闭塞性脑梗死中的应用分析[J].脑与神经疾病杂志,2017,25(12):765-768.
[9]向欣,杨华,彭瀚,等.Solitaire AB支架取栓治疗前循环急性脑梗死的疗效及中期随访结果[J].实用医学杂志,2016,32(7):1055-1057.
[10]陈甲,杨世泉,余本松,等.Solitaire AB支架取栓治疗急性脑梗死26例疗效分析[J].安徽医学,2016,37(9):1081-1084.
[11]于海龙,徐俊,李晓波,等.血管事件健康风险评分对急性脑血管闭塞患者Solitaire AB支架取栓术预后的预测价值[J].中华老年心脑血管病杂志,2017,19(11):1170-1175
[2]向欣,杨华,彭瀚,等.Solitaire AB支架取栓治疗前循环急性脑梗死的疗效及中期随访结果[J].实用医学杂志,2016,32(7):1055-1058.
[3]吴迎春,王俊梅,王哲,等.尿激酶静脉溶栓联合Solitaire AB支架取栓在前循环大动脉急性闭塞性脑梗死治疗中的应用研究[J].脑与神经疾病杂志,2017,25(8):497-502.
[4]张江,王大力,彭延波,等.脑卒中常用量表对急性脑梗死患者死亡预测的价值[J].中华老年心脑血管病杂志2011,13(12):1108-1111.
[5]张继红,田开语,李雪松,等.MMSE量表联合Barthel指数在老年脑卒中患者认知障碍评价中的应用[J].中国伤残医学,2012,20(5):30-32.
[6]傅懋林,戴为正,张永刚,等.Solitaire支架动脉取栓术联合多模式血管再通术治疗急性脑梗死疗效观察[J].天津医药,2017,45(10):1053-1057.
[7]杨云娜,李彤,孙永全,等.Solitaire AB支架机械取栓联合动脉溶栓治疗急性缺血性脑卒中疗效观察[J].安徽医学,2015,36(6):669-672.
[8]张正祥,叶民,周宁,等.SolitaireAB支架取栓治疗在急性脑动脉闭塞性脑梗死中的应用分析[J].脑与神经疾病杂志,2017,25(12):765-768.
[9]向欣,杨华,彭瀚,等.Solitaire AB支架取栓治疗前循环急性脑梗死的疗效及中期随访结果[J].实用医学杂志,2016,32(7):1055-1057.
[10]陈甲,杨世泉,余本松,等.Solitaire AB支架取栓治疗急性脑梗死26例疗效分析[J].安徽医学,2016,37(9):1081-1084.
[11]于海龙,徐俊,李晓波,等.血管事件健康风险评分对急性脑血管闭塞患者Solitaire AB支架取栓术预后的预测价值[J].中华老年心脑血管病杂志,2017,19(11):1170-1175