摘要
目的探讨桥接治疗对老年后循环大血管闭塞的急性脑卒中患者的安全性和有效性。方法前瞻性收集我院收治的老年后循环大血管闭塞的急性脑卒中患者160例,随机分为桥接组80例和对照组80例。桥接组给予溶栓治疗,桥接机械取栓;对照组直接行机械取栓,比较2组预后和不良反应。结果2组治疗后美国国立卫生研究院卒中量表(NIHSS)评分、基底动脉CT血管成像(BATMAN)评分较治疗前降低(P<0.01),桥接组治疗后NIHSS评分、BATMAN评分显著低于对照组[(6.54±1.23)分vs(7.12±0.98)分,(2.12±0.34)分vs(2.87±0.44)分,P<0.01]。2组脑梗死后出血转化比较无显著差异(P>0.05)。桥接组术中取栓次数显著少于对照组[(2.43±0.33)次vs(2.98±0.41)次,P<0.01]。2组治疗后改良的Rankin量表(mRS)评分整体比较,差异有统计学意义(P<0.05),桥接组治疗后mRS评分0~1分比例显著高于对照组(52.50%vs27.50%,P<0.05)。结论溶栓治疗桥接机械取栓可显著改善老年后循环大血管闭塞的急性脑卒中患者神经功能。
Objective To explore the safety and eefectiveness of bridging therapy in elderly patients with acute stroke due to posterior circulation large vessel occlusion.Methods A total of 160 eld-erly patients with acute stroke caused by posterior circulation large vessel occlusion admitted to our department were prospectively recruited and randomly divided into bridging group(n=80)and control group(n=80).The bridging group received thrombolysis treatment and then mechan-ical thrombectomy.The control group received mechanical thrombectomy directly.Prognosis and adverse reactions were compared between the two groups.Results The N1HSS score and BATMAN score after treatment were significantly decreased in both groups(P<0.01),and the two scores were obviously lower in the bridging group than the control group(6.54±1.23 ra 712±0.98,2.12±0.34 ra 2.87±0.44,P<0.01).There was no statistical difference in the conversion rate of bleeding after cerebral infarction between the two groups(5.00%vs 3.75%,P>0.05).The number of intraoperative thrombus removal was significantly lower in the bridging group than the control group(2.43±0.33 vs 2.98±0.41,P<0.01).Remarkabee difference was observed in the mRS score between the two groups after treatment(P<0.05),with the proportion of mRS score ranging from 0 to 1 larger in the bridging group than the control group(52.50%vs 27.50%,P<0.05).Conclusion Bridging thrombolysis can significantly improve the neurological function in elderly patients with acute stroke due to posterior circulation occlusion.
作者
刘志广
李再利
智文虹
郝宁
曹旭
曹培卫
Liu Zhiguang;Li Zaili;Zhi Wenhong;Hao Ning;Cao Xu;Cao Peiwei(Department of Neurology,Xuzhou Central Hospital,Xuzhou Clinical College of Xuzhou Medical University,Xuzhou 221009,Jiangsu Province,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2023年第12期1302-1305,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
徐州市科技项目(KC21234)。
关键词
卒中
脑梗死
球囊取栓术
预后
桥接治疗
stroke
brain infarction
balloon embolectomy
prognosis
bridging therapy
