摘要
目的探究血管内介入联合替罗非班治疗超溶栓时间窗急性脑梗死的临床效果。方法前瞻性选择2019年1月至12月我院收治的超溶栓时间窗急性脑梗死患者68例作为研究对象,随机分为对照组与观察组各34例。对照组患者行Solitaire AB支架取栓术治疗,观察组在Solitaire AB支架取栓术过程中经动脉鞘管注射替罗非班,比较两组患者治疗前后大脑血流学指标、神经功能(NIHSS)、日常生活自理能力(ADL)评分变化情况,并随访1年记录两组主要不良脑血管事件的发生情况。结果治疗前,两组患者左右侧大脑中动脉、基底动脉血流比较差异无统计学意义(P>0.05)。治疗后2周复查,观察组左右侧大脑中动脉、基底动脉血流均显著高于对照组(P<0.05)。观察组患者治疗后2周的NIHSS评分明显低于对照组,ADL评分明显高于对照组(P<0.05)。观察组治疗后相关出血事件发生率5.88%,与对照组比较,差异无统计学意义(P>0.05)。随访1年,观察组主要不良脑血管事件发生率5.88%,较对照组(23.53%)明显降低(P<0.05)。结论血管内介入联合替罗非班治疗超溶栓时间窗急性脑梗死能够有效改善患者大脑动脉血流,促进神经功能及日常生活自理能力恢复,并可显著减少不良脑血管事件发生,改善预后,值得推广应用。
Objective To explore the clinical effect of intravascular intervention combined with tirofiban on acute cerebral infarction beyond the thrombolytic time window.Methods A retrospective study was conducted on 68 patients with acute cerebral infarction beyond the thrombolysis time window admitted to our hospital from January to December 2019.The patients were divided into the control group and the observation group with 34 cases in each according to different treatment plans.The control group patients underwent Solitaire AB stent thrombectomy,while the observation group received injection of tirofiban through the arterial sheath during Solitaire AB stent thrombectomy.The changes of cerebral blood flow indexes,neurological function(NIHSS),and self-care ability(ADL)scores of the two groups were compared before and after treatment,and the occurrence of major adverse cerebrovascular events in the two groups were recorded during a 1-year follow-up.Results Before treatment,there was no statistically significant difference in blood flow between the left and right middle cerebral arteries and basilar arteries between the two groups(P>0.05).After 2 weeks of treatment,follow-up examination showed that the blood flow of the left and right middle cerebral arteries and basilar arteries in the observation group was significantly higher than that in the control group(P<0.05).After 2 weeks of treatment,the NIHSS score of the observation group patients was significantly lower than that of the control group,and the ADL score was significantly higher than that of the control group(P<0.05).The incidence of related bleeding events after treatment in the observation group was 5.88%,and there was no statistically significant difference compared to the control group(P>0.05).Following up for one year,the incidence of major adverse cerebrovascular events in the observation group was 5.88%,which was significantly lower than 23.53%in the control group(P<0.05).Conclusion The combination of intravascular intervention and tirofiban in the treatme
作者
熊娟
林丹
周玲
庞月珊
Xiong Juan;Lin Dan;Zhou Ling(Department of General Medical,Nanchong Central Hospital,Nanchong,Sichuan 637000;Interal Medical,the Third People's Hospital of Nanchong,Nanchong,Sichuan 637000,China)
出处
《四川医学》
CAS
2023年第10期1019-1023,共5页
Sichuan Medical Journal
