摘要
目的评价机械取栓和静脉溶栓治疗急性脑梗死的临床疗效。方法本研究为回顾性队列研究,选取2013-05~2016-10在西安交通大学第一附属医院神经内科住院,并且接受静脉溶栓或者机械取栓的急性脑梗死患者作为研究对象,收集两组患者的基线资料、治疗后临床结局、住院时间、住院医疗费用等数据,治疗后临床结局评价采用发病90 d后改良RANKIN评分(mRS),将研究对象分为静脉溶栓和机械取栓两组,对以上数据进行分析对比。结果机械取栓组有8例(30.8%)患者发病90 d后预后良好,采用改良RANKIN量表(mRS)评分0-1分,静脉溶栓组没有患者发病90 d后mRS分数达到0-1分(P=0.025);机械取栓组患者术后身体其他部位发生出血仅有1例(3.8%),而静脉溶栓组患者有6例(46.2%,P=0.001);机械取栓组患者入院总医疗费用及每日平均医疗费用均高于静脉溶栓组患者(P<0.001)。多因素Logistic回归分析发现,调整年龄和入院后美国国立卫生院卒中量表评分(NIHSS)后,与静脉溶栓相比,机械取栓明显降低了身体其他部位出血的风险(OR=0.018,95%CI 0.001-0.500)。结论机械取栓从功能恢复和安全性方面均优于静脉溶栓。
Objective To evaluate the clinical outcome of mechanical thrombectomy（MT） and intravenous thrombolysis （IVT） in the treatment of acute cerebral infarction. Methods This study was a retrospective cohort study. Acute cerebral infarction patients who admitted to the Department of Neurology in First Affiliated Hospital of Xi＇ an Jiaotong University from May 2013 to October 2016 and received intravenous thrombolysis（IVT） or mechanical thrombectomy（MT） were enrolled in this study. The following data were collected and analyzed between two groups（ IVT and MT） ： baseline data at the admission of hospital, clinical outcomes after treatment, length of hospital stay and medical expenditure during hospitalization. The modified Rankin scale（mRS） at 90 d after stroke was used to evaluate the clinical outcomes. Results There were eight patients（30. 8%） with mRS 0 - 1 at 90 d in MT group and no one in IVT group（P=0. 025）. The extracerebral bleeding happened in only one patient（3.8%） in MT group and six patients（46. 2%） in IVT group（P = 0. 001 ）. The total medical expenditure and daily average medical expenditure during hospitalization were higher in MT group than in IVT group（ P 〈 0. 001 ）. Multivariate Logistic regression analysis showed that after adjusting for age and baseline National Institute of Health Stroke Scale （NIHSS） , the odds ratio was 0. 018 （95% CI 0. 001 -0. 500） in MT group compared with IVT group. Conclusion MT may be superior to IVT in terms of functional outcome and safety.
出处
《山西医科大学学报》
CAS
2018年第1期68-72,共5页
Journal of Shanxi Medical University
基金
陕西省科技攻关项目(2011K12-05-12)
关键词
机械取栓
静脉溶栓
急性脑梗死
安全性
mechanical thrombectomy
intravenous thrombolysis
acute cerebral infarction
safety
