| 冼华玮.局部溶栓联合急诊支架成形开通术对急性颅内动脉闭塞病人闭塞血管再开通率的影响[J].安徽医药,2020,24(5):1011-1014. |
| 局部溶栓联合急诊支架成形开通术对急性颅内动脉闭塞病人闭塞血管再开通率的影响 |
| Effects of local thrombolysis combined with emergency stenting on the recanalization rate of occlusive vessels in patients with acute intracranial occlusion |
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| DOI：10.3969/j.issn.1009?6469.2020.05.041 |
| 中文关键词: 颅内栓塞 脑梗死 血栓溶解疗法 血管成形术，气囊 组织型纤溶酶原激活物 支架 |
| 英文关键词: Intracranial embolism Brain infarction Thrombolytic therapy Angioplasty,balloon Tissue plasminogen activator Stents |
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| 中文摘要: |
| 目的探讨局部溶栓联合急诊支架成形开通术对急性颅内动脉闭塞病人闭塞血管再开通率的影响。方法回顾性分析 2015年 6月至 2018年 6月郑州大学附属洛阳中心医院收治的 140例急性缺血性脑卒中病人临床资料，根据治疗方案分为观察组( n＝66)和对照组( n＝74)两组均予以急诊支架成形开通术，观察组在此基础上联合局部溶栓(组织型纤溶酶原激活物)治疗。评估两组术前、术后 1d、术，后 7d时神经损伤程度［美国国立卫生研究院卒中量表( NIHSS)］比较两组病人闭塞血管再通率和临床疗效，随访 3个月评估病人预后状况［改良 Rankin量表( mRS)］。结果 ①术后 1d、，术后 7d观察组 NIHSS得分(10.94±2.42)分、(8.42±2.76)分，对照组 NIHSS得分( 14.51±3.16)分、(11.66±3.05)分均低于术前( 18.88±4.33)分、(19.95±4.48)分( P＜0.05)且随时间变化而降低( P＜0.05)，观察组各时间点 NIHSS得分均低于对照组( P＜0.05)； ②观察组再通率为 93.94%(62/66，对照组再通率为 82.43%(61/74)；观察组闭塞血管再通率高于对照组( χ2＝4.330，P＝0.037)； ③术后 7d，观察组治疗总有效率 93.94%高于对照组 82.43%(P＜0.05)； ④随访 3个月后，观察组预后良好率 65.15%高于对照组 45.95%(P＜ )，0.05)。结论局部溶栓联合急诊支架成形开通术能提高闭塞血管再开通率，并有利于改善病人神经功能和预后状况。 |
| 英文摘要: |
| Objective To explore the effects of local thrombolysis combined with emergency stenting on the recanalization rate ofocclusive vessels in patients with acute intracranial occlusion. Methods The clinical data of 140 patients with acute ischemicstroke admitted in Luoyang Central Hospital Affiliated to Zhengzhou University from June 2015 to June 2018 were retrospectivelyanalyzed.According to the treatment regimens，they were divided into the observation group(n＝66)and the control group(n＝74). The two groups were treated with emergency stenting，and based on which the observation group was combined with local thrombo? lytic therapy(tissue plasminogen activator).The degree of nerve injury［National Institutes of Health Stroke Scale(NIHSS)］was as? sessed before surgery，at 1 d after surgery and at 7 d after surgery.The recanalization rate of occlusive vessels and clinical efficacywere compared between the two groups.After 3 months of followed up，the prognosis status［modified Rankin scale(mRS)］ was evaluated.Results The NIHSS scores in observation group［( 10.94±2.42)，(8.42±2.76)］ and control group［( 14.51±3.16)，(11.66±3.05)］at 1 d after surgery and at 7 d after surgery were lower than those before surgery［(18.88±4.33)，(19.95±4.48)］( P＜0.05)and the scores were decreased with time(P＜0.05)，and the NIHSS score in the observation group was lower than that in group at each time point(P＜0.05).The recanalization rate of occlusive vessels in observation group was higher than that in control group(93.94% vs. 82.43%，P＜0.05).The total effective rate of treatment in observation group was higher than that in control group at 7 d after operation(93.94% vs. 82.43%，P＜0.05).After 3 months of follow?up，the good rate of prognosis in ob? servation group was higher than that in control group(65.15% vs. 45.95%，P＜0.05).Conclusion Local thrombolysis combinedwith emergency stenting can improve the recanalization rate of occlusive vessels and improve the neurological function and progno?sis of patients. |
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