摘要
目的:探讨介入取栓治疗急性前循环大动脉闭塞(LAVO)的有效性及对患者预后生活能力的影响。方法:选取120例LAVO患者为研究对象,根据治疗方案不同分为研究组(n=67)及对照组(n=53)。对照组患者采用静脉溶栓方式治疗;研究组患者采用静脉溶栓联合介入取栓方式治疗。比较两组患者治疗后即刻、24 h、1周、2周的美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)评分及改良脑梗死溶栓分级(mTICI)≥2b例数;出院后随访90 d,比较两组患者不良事件发生情况及mRS评分对预后的评估情况。结果:研究组患者发病至治疗时间长于对照组(P<0.05);治疗后即刻及治疗后24 h,两组患者NIHSS及mRS评分比较,差异无统计学意义(P>0.05);治疗后1周、2周,研究组患者NIHSS及mRS评分低于对照组(P<0.05),研究组mTICI≥2b高于对照组(P<0.05)。90 d随访期间,研究组患者预后不良率低于对照组(P<0.05);mRS评分低于对照组(P<0.05);对照组预后不良风险高于研究组(χ^(2)=12.031,P=0.001)。结论:治疗急性LAVO采用介入取栓效果更佳,且预后不良风险更低,患者生活能力恢复更好,值得临床推广。
Objective:To investigate the efficacy of interventional thrombectomy for acute anterior circulation arterial occlusion and its influence on prognosis and life ability of patients.Methods:A total of 120 patients with LAVO were selected as the study subjects,and they were divided into study group(67 cases)and control group(53 cases)according to the treatment plan independently selected by patients and their families.Patients in the control group were treated with intravenous thrombolytic therapy,and patients in the study group were treated with intravenous thrombolytic therapy combined with interventional thrombectomy.The national institutes of health stroke scale(NIHSS),modified Rankin scale(mRS)score and modified cerebral infarction thrombolysis grading(mTICI)≥2b cases in the two groups were observed immediately,24 h,1 w and 2 w after treatment.Patients in both groups were followed up 90 days after discharge to observe the incidence of adverse events and mRS score to evaluate the prognosis.Results:The time from onset to treatment in the study group was higher than that in the control group(P<0.05).There were no significant differences in NIHSS and mRS scores between the two groups immediately after treatment and within 24 h after treatment(P>0.05).NIHSS and mRS scores in the study group were significantly lower than those in the control group at 1 w and 2 w after treatment(P<0.05).MTICI≥2b in study group was significantly higher than that in control group(P<0.05).During the 90-day follow-up,the poor prognosis rate of the study group was significantly lower than that of the control group(P<0.05),mRS score in the study group was significantly lower than that in the control group(P<0.05).The risk of poor prognosis in control group was significantly higher than that in study group(χ^(2)=12.031,P=0.001).Conclusion:Interventional thrombectomy in the treatment of acute anterior circulation arterial occlusion has better effect,lower risk of poor prognosis and better recovery of patients living ability,which is worthy of clinical promotion.
作者
欧念飞
梁乐
蒋柳结
黄显春
罗景林
OU Nian-fei;LIANG Le;JIANG Liu-jie;HUANG Xian-chun;LUO Jing-lin(Department of Neurology,Guidong People's Hospital of Guangxi Zhuang Autonomous Region,Wuzhou 543001,Guangxi,China)
出处
《川北医学院学报》
CAS
2022年第6期721-724,共4页
Journal of North Sichuan Medical College
基金
广西壮族自治区贺州市科学研究与技术开发计划项目(贺科技20030)。
关键词
急性前循环大动脉闭塞
介入取栓
有效性
预后生活能力
Acute anterior circulation arterial occlusion
Interventional thrombectomy
Effectiveness
Prognostic life ability
