|
|
|
| Comparison of the Therapeutic Effects of Mechanical Thrombectomy and Emergency Intra-arterial Thrombolysis in Patients with Acute Cerebral Infarction |
| XU Weili, WANG Hongyu, ZHANG Yi |
| Emergency Department, The Seventh People's Hospital of Zhengzhou, Zhengzhou Henan 450000 |
|
|
|
|
Abstract 【Objective】To compare the efficacy of mechanical thrombectomy (MT) and emergency intra-arterial thrombolysis (IAT) in the treatment of patients with acute cerebral infarction. 【Methods】A retrospective analysis was conducted on the data of 118 patients with acute cerebral infarction treated with MT or IAT in our hospital, including 66 cases in the MT group and 52 cases in the IAT group. The clinical efficacy of two groups of patients was compared, including the National Institutes of Health Stroke Scale (NIHSS) score before and after treatment, puncture to recanalization time, vascular recanalization rate, residual stenosis rate ≤ 30%, incidence of symptomatic intracranial hemorrhage within 24 hours, and 90 days mortality rate after surgery. 【Results】The total effective rate of the MT group was higher than that of the IAT group (P<0.05); After 3 days of treatment, the NIHSS scores of both groups of patients were lower than before treatment (P<0.05), and the MT group was lower than the IAT group (P<0.05); The time from puncture to recanalization in the MT group was shorter than that in the IAT group (P<0.05), and the vascular recanalization rate in the MT group was higher than that in the IAT group (P<0.05); There was no statistically significant difference (P>0.05) in the residual stenosis rate of ≤ 30%, the incidence of symptomatic intracranial hemorrhage within 24 hours, and the mortality rate at 90 days after surgery between the two groups of patients. 【Conclusion】 Compared with IAT, MT can improve vascular recanalization rate and prognosis in patients with acute cerebral infarction.
|
|
Received: 20 October 2023
|
|
|
|
|
|
[1] MASSON A, BOULOUIS G, JANOT K, et al. Acute hydrocephalus and delayed cerebral infarction after aneurysmal subarachnoid hemorrhage[J].Acta Neurochir (Wien),2022, 164(9):2401-2408.
[2] 朱德坤,王艳,李艳芳,等.阿替普酶静脉溶栓联合尤瑞克林及丁苯酞软胶囊治疗急性脑梗死疗效研究[J].重庆医学,2021,50(1):149-151.
[3] WANG X F, WANG M, LI G, et al. Efficacy of Solitaire AB stent-release angioplasty in acute middle cerebral artery atherosclerosis obliterative cerebral infarction [J].World J Clin Cases,2021, 9(19):5028-5036.
[4] 王一超,汤有飞.大脑中动脉供血区急性期脑梗死尿激酶超早期选择介入动脉溶栓的临床分析[J].贵州医药,2020,44(5):735-736.
[5] 林琳,冯岚,王文尖,等.尿激酶动脉溶栓联合活血化瘀汤对急性脑梗死临床疗效及安全性评价[J].中华中医药学刊,2020,38(11):118-120.
[6] OHASHI K, FUJIWARA K, OSANAI T, et al. Potential crowdedness of mechanical thrombectomy and cerebral infarction mortality in Japan:application of inverted two-step floating catchment area method [J].J Stroke Cerebrovasc Dis,2022, 31(9):1066-1074.
[7] 中华医学会急诊医学分会卒中学组,中国卒中学会急救医学分会. 急性脑梗死溶栓治疗急诊绿色通道构建专家共识[J].中华急诊医学杂志,2017,26(9):995-998.
[8] 符金岛,杨辉,王英霞,等.阿替普酶联合小剂量替罗非班对急性脑梗死患者血清细胞因子NIHSS评分的影响[J].河北医学,2022,28(6):1041-1047.
[9] WILL L, MAUS V, MAURER C, et al. Mechanical thrombectomy in acute ischemic stroke using a manually expandable stent retriever (Tigertriever) :preliminary single center experience [J].Clin Neu,2021, 31(2):491-497.
[10] DONG X L, XU G D, SONG Y X, et al. Comparative study on treatment of acute cerebral infarction between mechanical thrombectomy by micro catheter and thrombectomy by Solitaire AB stent [J].Medicine (Baltimore),2022,101(14):968-977.
[11] NOGUEIRA R C, LAM M Y, LLWYD O, et al. Cerebral autoregulation and response to intravenous thrombolysis for acute ischemic stroke [J].Sci Rep,2020, 10(1):105-114.
[12] 侯凯文,李沛城,陈珑,等.机械取栓术治疗急性缺血性脑卒中伴恶性肿瘤患者效果分析[J].介入放射学杂志,2022,31(9):852-856.
[13] 刘振生,孙勇,匡雄伟,等.急性脑梗死机械取栓后引流静脉早显与脑出血转化的关系[J].中华放射学杂志,2020,54(1):42-47.
[14] WANG J, QIAN J C, FAN L, et al. Efficacy and safety of mechanical thrombectomy for M2 segment of middle cerebral artery:a systematic review and meta-analysis [J].J Neurol,2021, 268(7):2346-2354.
[15] 胡国鹏,赵满栋,梁宁博.动脉溶栓联合机械取栓治疗急性脑梗死的近远期疗效观察[J].贵州医药,2021,45(5):705-706. |
|
|
|
2024, Vol. 41 
