动静脉联合溶栓与机械取栓治疗急性脑梗死的临床疗效及对患者预后的影响

摘要

Objective: To investigate the clinical efficacy of intravenous thrombolysis combined with mechanical thrombectomy for acute cerebral infarction and its effect on prognosis. Method:96 patients with a-cute cerebral infarction in our hospital were selected and divided into Intravenous thrombolysis group and Thrombectomy group. There were 12 cases in the mechanical thrombectomy group, and the other in the intra-venous thrombolysis group, including thrombolysis in 22 cases, intravenous thrombolysis in 46 cases, and in-travenous thrombolysis in patients with arteriovenous shunt in 16 cases. The clinical efficacy and NIHSS score of the two groups were compared. Results: The total effective rate was 83.33％,higher than Bridging group (62.50％), artery group (54.55％) and the venous group (39.13％), the difference was statistically signifi-cant ( P<0.05);After treatment, the NIHSS scores of the four groups were decreased;and arterial thromboly-sis group and intravenous thrombolysis group and arteriovenous thrombolysis bridging group, thrombectomy group total vascular recanalization rate, lower NIHSS score, the difference has statistical significance ( P<0. 05);The incidence of intracranial hemorrhage occurred in 4 cases of arterial thrombolysis group (18.18％), Venous group of 8 cases ( 17. 39％) , Arteriovenous bridging group of 2 case ( 12. 5％) , The thrombectomy group 2 case (16.67％),there was no significant difference (P>0.05). Conclusion:The use of thrombectomy and thrombolysis method has certain therapeutic effect on acute cerebral infarction, but mechanical thrombec-tomy can effectively improve the recanalization rate, NIHSS score and clinical curative effect, promote the re-covery of physiological function of the patients.%目的:探究动静脉联合溶栓与机械取栓治疗急性脑梗死的临床疗效及对患者预后的影响.方法:选择我院的急性脑梗死患者96例,将患者随机分为动静脉联合溶栓组及机械取栓组进行治疗.机械取栓组12例.动静脉联合溶栓组84例包括动脉溶栓22例,静脉溶栓46例,动静脉桥接溶栓16例.比较两组临床疗效、NIHSS评分的变化.结果:取栓组总有效率83.33％高于动静脉桥接组(62.50％)高于动脉组(54.55％)高于静脉组(39.13％),差异具有统计学意义(P<0.05);经治疗,四组NIH-SS评分均降低;与动脉溶栓组、静脉溶栓组及动静脉桥接溶栓组比较,取栓组血管总再通率较高、NIHSS评分较低,差异具有统计学意义(P<0.05);颅内出血的发生率在动脉溶栓组4例(18.18％),静脉组8例(17.39％),动静脉桥接组2例(12.5％),取栓组2例(16.67％),差异无统计学意义(P>0.05).结论:使用取栓及溶栓方法均对急性脑梗死具有一定的治疗效果,但机械取栓能够有效提高血管再通率、NIHSS评分及临床疗效,更好的促进患者的生理功能的恢复.