摘要
目的研究机械取栓治疗静脉溶栓无效急性中重度脑梗死的效果。方法选取2018年2月至2019年2月梅州市人民医院神内二科收治的50例急性中重度脑梗死患者进行研究,按照随机数表法将患者分为观察组和对照组各25例。对照组患者静脉给予单纯阿替普酶药物溶栓后血管无再通,24 h后经过CT检查排除继发性脑出血后给予调脂抗栓对症治疗,观察组患者给予静脉阿替普酶溶栓治疗后血管无再通,再对患者进行机械取栓治疗。比较两组患者治疗前、治疗后14 d、治疗后28 d的神经功能受损情况(NIHSS评分)和颅内出血率,以及治疗后28 d的治疗效果。结果观察组患者的治疗总有效率为60.0%,明显高于对照组患者的28.0%,差异有统计学意义(P<0.05);治疗前两组患者的NIHSS评分比较差异无统计学意义(P>0.05),治疗后14 d与治疗后28 d,两组患者的NIHSS评分均明显降低,且观察组患者的NIHSS评分分别为(12.73±2.62)分、(10.73±2.22)分,明显低于对照组的(17.25±2.15)分、(15.65±2.35)分,差异均有统计学意义(P<0.05);观察组患者的颅内出血率为20.0%,略高于对照组的12.0%,但差异无统计学意义(P>0.05)。结论静脉溶栓无效急性中重度脑梗死患者采用机械取栓治疗能有效提高治疗效果。
Objective To study the effect of mechanical thrombectomy in the treatment of acute moderate and severe cerebral infarction when intravenous thrombolysis was ineffective.Methods From February 2018 to February 2019,50 patients with acute moderate and severe cerebral infarction admitted to Department of NeurologyⅡ,Meizhou People's Hospital,were selected for study.According to random number table,the patients were divided into observation group and control group with 25 patients each.In the control group,the blood vessels did not reopen after intravenous administration of pure ateplase,and after 24 hours of CT examination,the patients in the observation group were treated with lipid regulating and antithrombotic therapy after elimination of secondary cerebral hemorrhage.In the observation group,the blood vessels were not reopened after intravenous administration of ateplase,and then the patients were treated with mechanical thrombectomy.The neurological impairment(NIHSS score)and intracranial hemorrhage rate before treatment,14 days and 28 days after treatment were compared between the two groups.Results The total effective rate of the observation group was 60.0%,which were significantly higher than 28.0%of the control group(P<0.05).There were no significant difference in NIHSS scores between the two groups before treatment(P>0.05);14 days after treatment and 28 days after treatment,the NIHSS scores of the two groups were significantly reduced,and the NIHSS scores of the observation group were(12.73±2.62)points,(10.73±2.22)points,significantly lower than(17.25±2.15)points,(15.65±2.35)points of the control group(P<0.05).The rate of intracranial hemorrhage in the observation group were 20.0%,slightly higher than 12.0%in the control group,but the difference were not statistically significant(P>0.05).Conclusion Mechanical thrombectomy can effectively improve the therapeutic effect in patients with acute moderate and severe cerebral infarction.
作者
钟锐
周坤元
涂加善
ZHONG Rui;ZHOU Kun-yuan;TU Jia-shan(Department of NeurologyⅡ,Meizhou People's Hospital,Meizhou 514000,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第15期1961-1963,共3页
Hainan Medical Journal
基金
广东省2018年度梅州市社会发展科技计划项目(编号:190102122051673)。
关键词
脑梗死
中重度
机械取栓
静脉溶栓
神经功能
效果
Cerebral infarction
Moderate and severe
Mechanical thrombectomy
Intravenous thrombolysis
Neurological function
Effect
