血管内介入治疗前循环急性脑梗死的预后分析

梁余航+唐龙冲+方海波

【摘要】 目的：探讨单纯静脉溶栓、单纯机械再通与静脉溶栓联合机械再通治疗前循环急性脑梗死的临床效果及安全性。方法：选择急性前循环脑梗死患者94例，根据治疗方式的不同分为静脉溶栓组（n=41），机械再通组（n=28）与联合溶栓组（n=25）；静脉溶栓组采用单纯静脉溶栓治疗，机械再通组采用单纯机械再通治疗，联合溶栓组采用静脉溶栓聯合机械再通治疗。根据预后良好率、死亡率、血管再闭塞率及患者并发症发生情况比较三种方式的实际临床效果。结果：静脉溶栓组患者溶栓14 d后NIHSS评分比溶栓治疗前低，差异有统计学意义（P<0.05）；机械再通组与联合溶栓组患者溶栓治疗3 d后NIHSS评分比溶栓治疗前低（P<0.05）。联合溶栓组预后良好率最高（P<0.05）；机械再通组血管再闭塞率最低（P<0.05）。三组患者死亡率及并发症发生率比较，差异均无统计学意义（P>0.05）。结论：静脉溶栓对技术要求较低，机械再通起效较快，血管再闭塞率低，联合治疗起效快，预后良好率高。

【关键词】 静脉溶栓； 前循环； 脑梗死； 介入治疗； 预后分析

Prognostic Analysis of Intravascular Interventional Therapy for Anterior Circulation of Acute Cerebral Infarction/LIANG Yu-hang，TANG Long-chong，FANG Hai-bo.//Medical Innovation of China，2017，14（11）：034-037

【Abstract】 Objective：To explore the clinical effect and safety of intravenous thrombolysis，mechanical thrombolysis and intravenous thrombolysis combined with mechanical thrombolysis in the treatment of anterior circulation acute cerebral infarction.Method：A total of 94 cases of acute anterior circulation cerebral infarction were selected and divided into intravenous thrombolysis group （n=41），mechanical recanalization group （n=28） and combined thrombolysis group （n=25） according to the different treatment methods.Intravenous thrombolysis group was treated by intravenous thrombolysis.Mechanical recanalization group was treated by mechanical recanalization.The combination of thrombolysis and mechanical recanalization was used incombined thrombolysis group.According to good prognosis，mortality，Vascular Re occlusion rate and the incidence of complications，the actual clinical effects of three groups were compared.Result：After thrombolysis，the scores of NIHSS were lower than those before thrombolytic therapy（P<0.05）.NIHSS scores of mechanical recanalization group and combined thrombolysis group after thrombolytic therapy for 3 days were lower than those of before thrombolysis（P<0.05）.The rate of prognosis of combined thrombolysis group was the highest（P<0.05）.The rate of vessel re-occlusion of mechanical recanalization group was the lowest（P<0.05）.There were no statistical significances in mortality and the complication rate of three groups （P>0.05）.Conclusion：Intravenous thrombolysis has lower technical requirement，mechanical thrombolysis has rapider onset and lower re-occlusion rate，combined therapy has rapider onset and good prognosis.

【Key words】 Intravenous thrombolysis； Anterior circulation； Cerebral infarction； Interventional therapy； Prognosis analysis

First-authors address：Central Peoples Hospital of Zhanjiang，Zhanjiang 524037，China