| 周湘玲
，潘春联
，程朝辉.支架取栓与动脉溶栓治疗大脑中动脉栓塞超4.5小时
患者的对比研究[J].神经损伤功能重建,2018,13(7):335-337 |
| 支架取栓与动脉溶栓治疗大脑中动脉栓塞超4.5小时
患者的对比研究 |
| Comparative Study of Stent Thrombectomy and Arterial Thrombolysis in Treatment ofPatients with Middle Cerebral Artery Occlusion Over 4.5 Hours |
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| DOI： |
| 中文关键词: 支架取栓 动脉溶栓 大脑中动脉 栓塞 |
| 英文关键词: stenting thrombectomy arterial thrombolysis middle cerebral artery embolization |
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| 中文摘要: |
| 目的：对比研究支架取栓与动脉溶栓治疗急性大脑中动脉栓塞超4.5 h患者的临床疗效。方法：99例
急性大脑中动脉栓塞超过4.5 h的患者按治疗方式分为溶栓组41例和取栓组58例。溶栓组接受选择性动脉
溶栓治疗，取栓组接受Solitaire支架进行机械取栓治疗，手术结束前采用脑梗死溶栓试验（TICI）分级评价血
管再通情况，比较2组的手术时间；采用美国国立卫生研究院卒中量表（NIHSS）评价2组患者的预后情况；
比较2组发生不良反应情况；并于90 d进行随访。结果：取栓组的血管再通率、完全再通率明显高于溶栓组
（94.8%v.s.78.0%，67.2%v.s.41.5%，均P＜0.05）；取栓组的手术时间短于溶栓组（P＜0.05）；治疗后取栓组的
NIHSS评分优于溶栓组（P＜0.05）；取栓组治疗后总有效率为96.6%，高于溶栓组的87.8%（P＜0.05）；取栓组
的基本治愈率高于溶栓组（50.0%v.s.31.7%，P＜0.05）；溶栓组患者的颅内出血的比例高于取栓组（P＜0.05）；
90 d随访，取栓组恢复优于溶栓组（P＜0.05）。结论：支架取栓治疗可显著改善大脑中动脉栓塞超4.5 h患者
的临床预后，减少不良反应发生。 |
| 英文摘要: |
| To compare the clinical efficacy of stent thrombectomy and arterial thrombolysis in the
treatment of acute middle cerebral artery occlusion of more than 4.5 hours. Methods：Ninety-nine patients with
acute middle cerebral artery occlusion were divided into the thrombolytic group (n=41) and the thrombectomy
group (n=58) according to treatment method. Selective intra-arterial thrombolysis was performed on
thrombolysis group patients, and mechanical thrombectomy using the Solitaire stent was performed on
thrombectomy group patients. Thrombolysis in Cerebral Infarction (TICI) was used to evaluate the recanalization
of vessels prior to the conclusion of surgery, and the operation time of the two groups was compared. The
recovery of the two groups was evaluated by the National Institutes of Health Stroke Scale (NIHSS) score.
Adverse reactions were recorded and followed up at 90 days. Results：The recanalization rate and complete
recanalization rate of the thrombectomy group were significantly higher than those of thrombolysis group (94.8%
v.s. 78.0, 67.2% v.s. 41.5%, both P<0.05). The operation time of the thrombectomy group was lower than that of
the thrombolysis group (P<0.05). After treatment, the NIHSS score of the thrombectomy group was significantly
better than that of the thrombolysis group (P<0.05). The total effective rate of the thrombectomy group was
96.6%, which was significantly higher than the 87.8% rate of the thrombolysis group (P<0.05). The cure rate of
the thrombectomy group was significantly higher than that of the thrombolysis group (50.0% v.s. 31.7% , P<
0.05). The patients in the thrombolysis group had a higher rate of intracranial hemorrhage than those in the
thrombectomy group (P<0.05). At the 90-day follow-up, patients in the thrombectomy group showed better
recovery than those in the thrombolysis group (P<0.05). Conclusion：Stent thrombectomy can significantly
improve the clinical prognosis of patients with cerebral arterial embolization of over 4.5 hours |
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