摘要
目的比较急性大动脉闭塞性脑梗死患者直接动脉取栓和静脉溶栓后桥接动脉取栓的疗效。方法将2016年1月至2017年12月于我院就诊的66例急性大动脉闭塞性脑梗死患者分为直接动脉取栓组与静脉溶栓后桥接动脉取栓组(动脉取栓26例,静脉溶栓后桥接动脉取栓40例),分别使用相应的方案治疗,对比观察两组血管再通率、术后病死率、再出血风险以及治疗前后早期神经功能恶化(END),及应用Rankin量表(mRS)评价术后3个月预后。结果与直接动脉取栓组血管再通19例(73. 07%)、END10例(38. 46%)、3个月mRS评分(2. 73±1. 78)比较,静脉溶栓后桥接动脉取栓组血管再通29例(72. 50%)、END13例(32. 50%)无明显差异(P>0. 05),3个月mRS评分(1. 90±1. 46)明显降低(P<0. 05);与直接动脉取栓组出血3例(11. 54%)及死亡1例(3. 84%)比较,静脉溶栓后桥接动脉取栓组出血6例(15. 00%)及死亡2例(5. 00%)无明显差异(P>0. 05)。结论对于急性大动脉闭塞性脑梗死患者,静脉溶栓后桥接动脉取栓疗效优于直接动脉取栓,且没有增加出血及死亡率。
Objective To compare the effects of direct intra-artery throbectomy and that combined with intravenous thrombolysis on acute cerebral infarction(ACI)with large cerebral artery occlusion.Methods 66 ACI cases with large cerebral artery occlusion during the period from Jan.,2016 to Dec.,2017 were divided,according to different treatments applied,into 2 groups:direct group(direct intra-artery throbectomy applied,n=26)and combined group(intra-artery throbectomy combined with intravenous thrombolysis applied,n=40);the blood vessel re-canalization rate,postoperative mortality,risk of rebleeding,and pre- and post-operative early neurological deterioration(END)were observed and the modified Rankin scale(mRS)was applied in evaluating the prognosis at the time point of 3 months after operation.Results There existed no obvious differences in blood vessel recanalization rate and END between direct group[(19 cases(73.07%),10 cases(38.6%)]and combined group[29 cases(72.50%),13 cases(32.50%)](P>0.05)while the mRS score 3 months after operation in combined group(1.90±1.46)was much lower than that in direct group(P<0.05);bleeding occurred in 3 cases(11.54%)and death in 1 case(3.84%)in direct group while bleeding occurred in 6 cases(15.00%)and death in 2 cases(5.00%),the difference between the 2 groups was of no obvious significance(P>0.05).Conclusions Intra-artery throbectomy combined with intravenous thrombolysis is of better effect than direct intra-artery throbectomy on ACI with large cerebral artery occlusion,leading to no more bleeding or a higher mortality.
作者
鄢仕强
陈林
周海涛
许刚
胡明才
Yan Shiqiang;Chen Lin;Zhou Haitao;Xu Gang;Hu Mingcai(Department of Neurology,the People's Hospital of Dianjiang County,Chongqing,408300,P.R.China)
出处
《西南军医》
2019年第1期7-10,共4页
Journal of Military Surgeon in Southwest China
基金
2016年重庆市垫江县科技计划项目(项目编号:djkjxm2016jsyfysfyy028)
关键词
急性大动脉闭塞性脑梗死
直接动脉取栓
静脉溶栓后桥接动脉取栓
安全性
有效性
acute cerebral infarction(ACI)with large cerebral artery occlusion
direct intra-artery throbectomy
intra-artery throbectomy combined with intravenous thrombolysis
safety
effectiveness
