摘要
目的 探讨静脉溶栓联合机械取栓治疗急性缺血性脑卒中的临床效果及其对免疫功能、预后的影响。方法 选择2017年1—12月我院收治的急性缺血性脑卒中84例,根据治疗方法的不同分为观察组和对照组,每组各42例。对照组予常规治疗及静脉溶栓,观察组予常规治疗及静脉溶栓联合机械取栓。观察术后3个月的临床疗效,采用美国国立卫生研究院卒中量表(national institutes of health stroke scale, NIHSS)评估治疗前及治疗后1、2、3个月神经功能缺损情况,比较治疗前、治疗后3 d CD3+、CD4+、CD8+、CD4+/CD8+水平变化,记录预后及不良反应发生情况。结果 观察组、对照组临床总有效率分别为92.86%、73.81%,比较差异有统计学意义( P =0.034)。与对照组比较,观察组治疗后1个月NIHSS评分降低,差异有统计学意义( P <0.01);与本组治疗前比较,两组治疗后1、2、3个月NIHSS评分降低,差异有统计学意义( P < 0.05);与本组治疗后1个月比较,两组治疗后2、3个月NIHSS评分下降,差异有统计学意义( P <0.05);与本组治疗后2个月比较,两组治疗后3个月NIHSS评分降低,差异有统计学意义( P <0.05)。两组治疗后3 d CD3+、CD4+、CD8+、CD4+/CD8+水平比较差异有统计学意义( P <0.05);与本组治疗前比较,两组治疗后3 d CD3+、CD4+、CD4+/CD8+水平升高,CD8+水平降低,差异有统计学意义( P <0.05)。与对照组比较,观察组血管急性再闭塞率降低,差异有统计学意义( P <0.05)。两组治疗期间不良反应总发生率比较差异无统计学意义( P =0.746)。结论 静脉溶栓联合机械取栓治疗急性缺血性脑卒中有助于提高临床疗效,减轻神经功能缺损程度,增强机体免疫功能,极大改善患者预后。
Objective To investigate the clinical effect of intravascular thrombolysis combined with mechanical thrombectomy in the treatment of acute ischemic stroke (AIS) and its effect on immune function and prognosis. Methods Eighty-four cases of AIS admitted to our hospital from January to December 2017 were selected and divided into observation group ( n =42) and control group ( n =42) according to different treatment methods. The control group received conventional treatment and intravenous thrombolysis, while the observation group received conventional treatment and intravenous thrombolysis combined with mechanical thrombectomy. The clinical efficacy was observed 3 months after operation. The neurological deficits were assessed by National Institutes of Health Stroke Scale (NIHSS) before and 1, 2 and 3 months after treatment. The changes of CD3+, CD4+, CD8+, CD4+/CD8+ levels before and 3 d after treatment were compared, and the prognosis and adverse reactions were recorded. Results The total clinical effective rates of the observation group and the control group were 92.86% and 73.81%, respectively, with significant difference ( P =0.034). Compared with the control group, the NIHSS score of the observation group was decreased at 1 month after treatment, with statistical significance ( P <0.01);compared with those before treatment, the NIHSS scores of the two groups were decreased at 1, 2 and 3 months after treatment, with statistical significance ( P <0.05);compared with the group at 1 month after operation, the NIHSS scores of the two groups were decreased at 2 and 3 months after treatment, with statistical significance ( P <0.05). After 2 months of treatment, the NIHSS scores of the two groups were decreased at 3 months after treatment, and the difference was statistically significant ( P <0.05). After treatment, the levels of CD3+, CD4+, CD8+, CD4+/CD8+ in the two groups were significantly different ( P <0.05). Compared with those before treatment, the levels of CD3+, CD4+, CD4+/CD8+ in the two groups were increased while the levels of CD8+ were decreased at 3 days after treatment, suggesting significant differences ( P <0.05). Compared with the control group, the rate of acute vascular re-occlusion was decreased, suggesting significant differences ( P <0.05). There was no significant difference in the total incidence of adverse reactions between the two groups during treatment ( P =0.746). Conclusion Intravascular thrombolysis combined with mechanical thrombectomy for AIS can improve the clinical efficacy, reduce the degree of neurological deficits, improve the body's immune function, and greatly improve the patient's prognosis.
作者
杨占辉
尹学敬
王树平
YANG Zhan-hui;YIN Xue-jing;WANG Shu-ping(Department of Intervention Treatment, Harrison International Peace Hospital, Hengshui, Hebei 053000, China)
出处
《临床误诊误治》
2019年第9期81-86,共6页
Clinical Misdiagnosis & Mistherapy
基金
2015年度河北省医学科学研究重点课题计划(20150434)
河北省科技计划项目(132777197)
关键词
卒中
缺血性
机械取栓
静脉溶栓
预后
Stroke, ischemic
Mechanical thrombolysis
Intravascular thrombolysis
Prognosis
