【摘要】：目的:急性缺血性腦卒中是常見(jiàn)的腦血管病,發(fā)病率日益增多。靜脈溶栓和機(jī)械取栓為常見(jiàn)的有效治療方法。但關(guān)于單純機(jī)械取栓和機(jī)械取栓聯(lián)合靜脈溶栓在治療大血管閉塞性急性卒中中的療效及安全性對(duì)比存在爭(zhēng)議。本薈萃分析旨在對(duì)比上述兩種方法在治療治療大血管閉塞性急性卒中中的療效及安全性。方法:從數(shù)據(jù)庫(kù)(Pubmed,Google schalor,Cochrane library,clinicaltrial,中國(guó)知網(wǎng))中搜索符合納入排除標(biāo)準(zhǔn)的文章,并對(duì)文章進(jìn)行質(zhì)量評(píng)價(jià),根據(jù)質(zhì)量評(píng)價(jià)結(jié)果采用固定效應(yīng)模型進(jìn)行meta分析。結(jié)果:共6篇文章納入研究,共692個(gè)病人予以機(jī)械取栓聯(lián)合靜脈溶栓,244個(gè)病人予以單純機(jī)械取栓治療。上述兩種治療方法的死亡率(OR=0.70,95%CI 0.49-0.98,P=0.04)有統(tǒng)計(jì)學(xué)差異,而再通率(OR=0.86,95%CI 0.56-1.33,P=0.51);癥狀性腦出血率(OR=0.94,95%CI 0.48-1.85,P=0.87);3個(gè)月后m RS(0-2)的比率(OR=0.93,95%CI 0.69-1.27,P=0.66)無(wú)顯著差異。結(jié)論:機(jī)械取栓前進(jìn)行靜脈溶栓預(yù)處理可降低大血管閉塞性急性卒中在三個(gè)月內(nèi)的死亡率。而單純機(jī)械取栓和機(jī)械取栓聯(lián)合靜脈溶栓的再通率、腦出血率、3個(gè)月后m RS(0-2)比率無(wú)顯著差異。但由于本研究納入患者數(shù)量較少,為非隨機(jī)對(duì)照研究,故仍需要大樣本前瞻性隨機(jī)對(duì)照研究加以驗(yàn)證。
[Abstract]:Objective: acute ischemic stroke is a common cerebrovascular disease with increasing incidence. Intravenous thrombolysis and mechanical thrombolysis are common effective treatment methods. However, the efficacy and safety of mechanical and mechanical thrombolysis combined with intravenous thrombolysis in the treatment of acute stroke caused by macrovascular occlusion are controversial. The purpose of this meta-analysis is to compare the efficacy and safety of these two methods in the treatment of large-vessel occlusive acute stroke. Methods: the articles that met the exclusion criteria were searched from the database (Pubmed,Google schalor,Cochrane library,clinicaltrial, China knowledge Network), and the quality of the articles was evaluated. According to the results of the quality evaluation, the fixed effect model was used for meta analysis. Results: 692 patients were treated with mechanical thrombolysis combined with intravenous thrombolysis, and 244 patients were treated with mechanical thrombolysis. The mortality rate (OR=0.70,95%CI 0.49-0.98) was significantly different between the two treatments (OR=0.86,95%CI 0.56-1.33 P0.51), symptomatic intracerebral hemorrhage (OR=0.94,95%CI 0.48-1.85 P0.87) and m RS (0-2 (OR=0.93,95%CI 0.69-1.27P0.66). Conclusion: intravenous thrombolytic preconditioning before mechanical thrombolysis can reduce the mortality of acute stroke of macrovascular occlusion within 3 months. However, there was no significant difference between mechanical thrombolysis and mechanical thrombolysis combined with intravenous thrombolytic reopening rate, intracerebral hemorrhage rate and m RS (0-2 ratio 3 months later. However, due to the small number of patients included in this study, which is a non-randomized controlled study, it still needs to be verified by a large sample of prospective randomized controlled trials.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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本文編號(hào)：2213397