| 柳晓锋，李丽，侯永革，齐秀彦，谢少云，刘翠平，朱荣彦.不同血管再通方法治疗不同病因急性缺血性
脑血管病的临床分析[J].神经损伤功能重建,2018,13(9):433-436 |
| 不同血管再通方法治疗不同病因急性缺血性
脑血管病的临床分析 |
| Clinical Analysis of Different Vascular Recanalization Methods for Acute IschemicCerebrovascular Diseases of Various Etiology |
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| DOI： |
| 中文关键词: 急性缺血性脑血管病 静脉溶栓 机械取栓 |
| 英文关键词: acute ischemic cerebrovascular disease intravenous thrombolysis mechanical thrombectomy |
| 基金项目:2015年石家庄市科
学技术研究与发展
指 导 计 划 项 目
（15141293） |
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| 摘要点击次数: 2748 |
| 全文下载次数: 2951 |
| 中文摘要: |
| 目的：探讨不同血管再通方法对不同病因急性缺血性脑血管病患者的疗效。方法：80例急性缺血性
脑卒中患者，根据治疗方法分为静脉溶栓组30例、机械取栓组24例及联合治疗组26例。根据TOAST分型
标准将各组分为大动脉粥样硬化性卒中型（A型）、心源性栓塞型（B型）和其他病因型（C型）。评估患者治
疗后血管再通情况和出血转化情况。治疗前和治疗后3 d行美国国立卫生研究院卒中量表（NIHSS）评分，
治疗前及治疗后90 d评估日常生活能力Barthel指数（BI评分）、改良Rankin评分（mRS）。结果：治疗后，与
静脉溶栓组、机械取栓组比较，联合治疗组的NIHSS评分更低（P<0.05），BI评分、mRS≤2分比例、血管再通
比例更高（P<0.05），出血转化比例也更高（P<0.05）。机械取栓组中，治疗后，与A型、C型比较，B型NIHSS
评分更低（P<0.05），BI评分、mRS≤2分比例、血管再通比例更高（P<0.05）。房颤相关性栓塞患者中，治疗
后，与静脉溶栓组比较，机械取栓组和联合治疗组NIHSS评分均更低（P<0.05），BI评分、mRS≤2分比例、血
管再通比例均更高（P<0.05）；联合治疗组出血转化比例高于机械取栓组（P<0.05）。结论：急性缺血性脑血管
病超急性期血管再通治疗中，静脉溶栓对动脉粥样硬化性卒中型疗效最佳。而在房颤相关性脑栓塞患者
中，机械取栓可能为最佳选择。联合应用疗效好于单独治疗，但出血转化比例明显升高。 |
| 英文摘要: |
| To observe the effects of different methods of vascular recanalization on patients with
different causes of acute ischemic cerebrovascular disease. Methods: Eighty patients with acute ischemic stroke
were divided according to treatment method into intravenous thrombolysis group (n=30), mechanical
thrombectomy group (n=24), and combined treatment group (n=26). According to the TOAST classification
criteria, each group was further divided into three groups: large atherosclerotic stroke type (type A), cardiogenic
embolism type (type B), and other etiological type (type C). Patients were evaluated for status of blood vessel
recanalization and bleeding after treatment. Prior to and 3 days after treatment, patients were evaluated with the
National Institute of Health Stroke Scale (NIHSS). Patients were additionally evaluated prior to and 90 days after
treatment with the Barthel Index (BI) and modified Rankin Scale (mRS). Results: After treatment, compared
with the intravenous thrombolysis group and the mechanical thrombectomy group, NIHSS score of the combined
treatment group was lower (P<0.05) and BI, mRS≤2 ratio, and vascular recanalization rate were higher (P<
0.05); hemorrhagic transformation rate of the combined treatment group was also higher (P<0.05). In the
mechanical thrombectomy group, after treatment and compared with types A and C, type B showed lower NIHSS
score (P<0.05) and higher BI, mRS≤2 ratio, and vascular recanalization rate (P<0.05). In patients with
fibrillation associated with embolization, after treatment and compared with the intravenous thrombolysis group,
NIHSS score of the mechanical thrombectomy group and combined treatment group was lower (P<0.05) and BI,
mRS≤2 ratio, and vascular recanalization rate were higher (P<0.05). Hemorrhagic transformation rate in the
combined treatment group was significantly higher than that in the mechanical thrombectomy group (P<0.05).
Conclusion: In vascular recanalization therapy for acute ischemic cerebrovascular disease, intravenous
thrombolysis is the best treatment for atherosclerotic cerebral infarction. Mechanical thrombectomy may be the
best choice in patients with atrial fibrillation associated cerebral embolism. The effects of combined treatment
may be better than that of single treatment, but the hemorrhagic transformation rate is significantly higher |
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