【摘要】：目的比較血管內(nèi)支架成形術(shù)與內(nèi)科方式治療青年嚴(yán)重癥狀性大腦中動脈狹窄患者腦卒中二級預(yù)防的療效及安全性。方法收集該院2011年1月至2015年6月經(jīng)全腦血管造影術(shù)明確的嚴(yán)重癥狀性大腦中動脈狹窄(狹窄率大于或等于70%)患者77例,分為血管內(nèi)支架成形術(shù)組和內(nèi)科治療組,評估入院時改良Rankin評分(mRS評分)、美國國立衛(wèi)生院卒中量表(NIHSS)評分及入組后1年內(nèi)mRS評分和缺血性卒中復(fù)發(fā)、死亡、腦出血事件。結(jié)果血管內(nèi)支架成形術(shù)組與內(nèi)科治療組30d內(nèi)主要終點事件發(fā)生率分別為0%、5.77%,1年內(nèi)卒中復(fù)發(fā)率分別為4.35%、13.46%,兩組比較差異無統(tǒng)計學(xué)意義(P0.05)。兩組均無死亡、腦出血發(fā)生。血管內(nèi)支架成形術(shù)組與內(nèi)科治療組隨訪1年時mRS≤1分患者比例分別為91.30%、69.23%,兩組比較差異有統(tǒng)計學(xué)意義(P0.05);mRS≤2分的患者分別為95.65%、84.62%,兩組比較差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論血管內(nèi)支架成形術(shù)在嚴(yán)重癥狀性大腦中動脈狹窄是安全的,對降低青年再發(fā)卒中風(fēng)險比內(nèi)科治療更有效。
[Abstract]:Objective to compare the efficacy and safety of endovascular stenting and internal medicine for secondary prevention of stroke in young patients with severe symptomatic middle cerebral artery stenosis. Methods from January 2011 to June 2015, 77 patients with severe symptomatic middle cerebral artery stenosis (stenosis rate greater than or equal to 70%) were divided into two groups: endovascular stenting group and medical treatment group. The modified Rankin score (mRS score), the (NIHSS) score of the National Institutes of Health Stroke scale (NHS) and the mRS score and ischemic stroke recurrence, death and intracerebral hemorrhage events within 1 year after admission were evaluated. Results the incidence of major end-point events was 0%, 5.77% and 4.35%, 13.46% in endovascular stenting group and internal medicine group, respectively, and the recurrence rate of stroke within one year was 4.35% and 13.46%, respectively. There was no significant difference between the two groups (P0.05). There was no death and cerebral hemorrhage occurred in both groups. The percentage of patients with mRS 鈮，

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