本文選題：支架取栓 + 動(dòng)脈溶栓　； 參考：《山東醫(yī)藥》2017年46期

【摘要】：目的探討支架機(jī)械取栓治療急性大腦中動(dòng)脈栓塞的臨床療效。方法 116例急性大腦中動(dòng)脈栓塞患者按照治療方式分為動(dòng)脈溶栓組51例和支架取栓組65例。動(dòng)脈溶栓組給予選擇性動(dòng)脈溶栓治療,支架取栓組給予Solitaire支架進(jìn)行機(jī)械取栓治療。手術(shù)結(jié)束前采用腦梗死溶栓試驗(yàn)(TICI)分級(jí)評(píng)價(jià)血管再通情況,治療前及治療后7 d行美國(guó)國(guó)立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分判定臨床療效。術(shù)后24 h行顱腦CT檢查,并觀(guān)察皮膚、消化道出血情況,明確是否存在顱內(nèi)及其他部位出血。術(shù)后90、180 d采用改良Rankin量表(mRS)評(píng)分評(píng)估患者預(yù)后。結(jié)果支架取栓組、動(dòng)脈溶栓組血管再通率分別為96.9%(63/65)、76.5%(39/51),支架取栓組血管再通率高于動(dòng)脈溶栓組(P0.05)。支架取栓組總有效率高于動(dòng)脈溶栓組(P0.05)。支架取栓組在治療過(guò)程中無(wú)不良事件發(fā)生,動(dòng)脈溶栓組出現(xiàn)黑便1例,兩組出血發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。支架取栓組術(shù)后90、180 d時(shí)mRS評(píng)分均低于動(dòng)脈溶栓組(P均0.05)。結(jié)論支架機(jī)械取栓治療具有較高的血管再通率,可顯著改善急性大腦中動(dòng)脈栓塞患者的臨床療效和長(zhǎng)期預(yù)后,且不增加不良反應(yīng)的發(fā)生率。
[Abstract]:Objective to investigate the clinical effect of stent mechanical embolization in the treatment of acute middle cerebral artery embolism. Methods 116 patients with acute middle cerebral artery embolism were divided into thrombolytic group (51 cases) and stenting group (65 cases). Selective arterial thrombolytic therapy was performed in the arterial thrombolysis group and mechanical thrombolysis was performed in the stent removal group. Cerebral infarction thrombolytic test (TICI) was used to evaluate the recanalization of blood vessels before and 7 days after the operation, and the National Institutes of Health Stroke scale (NIHSS) was used to evaluate the clinical efficacy. Craniocerebral CT was performed 24 hours after operation, and the bleeding of skin and digestive tract was observed. The prognosis was evaluated by modified Rankin scale (Mrs) 90180 days after operation. Results the recanalization rate of artery thrombolytic group was 96.9% (63 / 65) and 76.5% (39 / 51) respectively. The recanalization rate of stent removal group was higher than that of arterial thrombolytic group (P0.05). The total effective rate of stenting group was higher than that of arterial thrombolysis group (P0.05). There were no adverse events in the stenting group and 1 case in the arterial thrombolysis group. There was no significant difference in the incidence of bleeding between the two groups (P0.05). The Mrs score of stent removal group was lower than that of arterial thrombolytic group at 90180 days postoperatively (P 0.05). Conclusion the stent mechanical thrombectomy has a high vascular recanalization rate and can significantly improve the clinical efficacy and long-term prognosis of patients with acute middle cerebral artery embolism without increasing the incidence of adverse reactions.
【作者單位】： 天津中醫(yī)藥大學(xué)第二附屬醫(yī)院;
【分類(lèi)號(hào)】：R743.33

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張洪俊;張叔辰;韓麗華;司永兵;解相禮;;大腦中動(dòng)脈栓塞并腦疝手術(shù)治療成功2例[J];中風(fēng)與神經(jīng)疾病雜志;1989年03期

2 唐穎馨;劉敏珍;丁鳳菲;張強(qiáng);潘鄧記;王偉;;小鼠大腦中動(dòng)脈栓塞模型的改良及評(píng)價(jià)[J];神經(jīng)損傷與功能重建;2012年02期

3 姜宏全;張黎明;劉魏松;李國(guó)霖;;兔大腦中動(dòng)脈栓塞前后血流速度的變化[J];中國(guó)傷殘醫(yī)學(xué);2011年06期

4 譚斐,金武,牛世貴;大鼠單側(cè)大腦中動(dòng)脈栓塞后腦內(nèi)乙酰膽堿酯酶的光鏡與電鏡酶組化研究[J];中風(fēng)與神經(jīng)疾病雜志;2001年01期

5 嚴(yán)家川,王景周,高東,何明利,陳曼娥;大腦中動(dòng)脈栓塞再灌注鼠腦一氧化氮合酶活性變化及地塞米松的治療效應(yīng)[J];中國(guó)危重病急救醫(yī)學(xué);2001年08期

6 彭伊o，

本文編號(hào)：2111922