阿替普酶静脉溶栓桥接Solitaire AB支架取栓术治疗急性脑梗死的疗效分析

目的 探讨阿替普酶静脉溶栓桥接Solitaire AB可回收支架取栓术在急性脑梗死溶栓时间窗内治疗的疗效和意义。方法 将2015年7月-2018年7月在本院治疗的68例急性脑梗死患者随机分为实验组(34例)和对照组(34例),实验组予以阿替普酶静脉溶栓桥接Solitaire AB可回收支架取栓术治疗,对照组予以单纯阿替普酶静脉溶栓治疗; 通过影像学检查分析2组治疗后颅内病变和并发症发生情况; 通过血管造影评估实验组血管再通率; 通过NIHSS评分评估2组治疗后神经功能情况; 通过Barthel指数和改良Rankin量表评分评估2组患者预后情况。结果 在急性脑梗死溶栓时间窗内阿替普酶静脉溶栓桥接Solitaire AB可回收支架取栓术治疗的血管再通率为94.1%,再通时间为(219.4±59.2)min,取栓次数为(2.5±1.1)次,所有患者均未出现颅内出血等并发症; 对比单纯阿替普酶静脉溶栓治疗,阿替普酶静脉溶栓桥接Solitaire AB可回收支架取栓术治疗的患者NIHSS评分、Barthel指数和改良Rankin量表评分均有显著优势。结论 在急性脑梗死溶栓时间窗内进行阿替普酶静脉溶栓桥接Solitaire AB可回收支架取栓是安全、有效的治疗方法,可以显著增加血管再通率、改善患者的神经功能和总体预后。

Therapeutic effect of intraveneous thrombolysis by alteplase bridged endovascular thrombectomy with the Solitaire AB stent retrieverin treatment of patients with acute cerebral infarction

ObjectiveTo study the therapeutic effect of intraveneous thrombolysis by alteplase bridged endovascular thrombectomy with the Solitaire AB stent retrieverin treatment of patients with acute cerebral infarction in the time-window of thrombolytic.Methods A total of 68 patients with acute cerebral infarction treated in our hospital were recruited from July 2015 to July 2018.All the patients were randomly divided into experimental group(34 patients)and control group(34 patients).The patients in experimental group were treated with intraveneous thrombolysis by alteplase bridged endovascular thrombectomy with the Solitaire AB stent retriever.The patients in control gourp were treated with intraveneous thrombolysis by alteplase.Imageological examination was performed to determine the development of intracranial lesions and incidence of complication.Angiography was performed to determine the vascular recanalization in experimental group.Neurological function of these two groups was determined by the NIHSS score after treatment.The prognosis was determined by the Barthel index and modified Rankin score.Results In the time-window of thrombolytic treatment for acute cerebral infarction,the vascular recanalization rate of intraveneous thrombolysis by alteplase bridged endovascular thrombectomy with the Solitaire AB stent retriever was 94.1%.The vascular recanalization time was(219.4±59.2)min,and the numbers of endovascular thrombectomy was 2.5±1.1.No complication was found in all patients.Compared with the control group,the NIHSS score,the Barthel index and the modified Rankin score were markedly better in the experimental group.Conclusion In the time-window of thrombolytic treatment for acute cerebral infarction,ntraveneous thrombolysis by alteplase bridged endovascular thrombectomy with the Solitaire AB stent retriever was a safe and effective treatment,which could observably increase the vascular recanalization rate and promote the prognosis of neurological function.