单纯支架取栓与静脉溶栓桥接支架取栓治疗颅内大血管闭塞的疗效分析

目的比较单纯支架取栓与静脉溶栓桥接支架取栓对急性大脑中动脉闭塞开通的有效性和安全性。方法回顾性分析发病6 h内颅内大血管急性闭塞病人48例临床资料，根据治疗方案的不同分为单纯支架取栓(支架取栓组)和静脉溶栓桥接支架取栓治疗(桥接治疗组)，比较2组基线资料，采用美国国立卫生研究院卒中量表(NIHSS)及改良Rankin评分(mRS)比较2组疗效，根据2组治疗后14 d NIHSS评分变化比较2组有效性，并观察病人90 d mRS预后、不良反应和病死情况。结果2组14 d有效率比较显示，累积有效率均较高(77.78%，85.71%)，差异无统计学意义，但桥接治疗组14 d基本治愈和显效总比例高于支架取栓组(P < 0.05)。2组病人入院到血管再通时间、取栓次数、预后、症状性颅内出血及1个月内全因病死率比较差异均无统计学意义(P>0.05)，桥接治疗组90 d预后良好率高于支架取栓组(P < 0.05)。结论单纯支架取栓与静脉溶栓桥接支架取栓均能快速开通颅内闭塞大动脉，桥接治疗组的短期及长期疗效更好。

Analysis of the efficacy of single stent thrombectomy and intravenous thrombolytic bridging stent thrombectomy in the treatment of intracranial large vessel occlusion

ObjectiveTo compare the efficacy and safety between single stent thrombectomy and intravenous thrombolytic bridging stent thrombectomy in the treatment of intracranial large vessel occlusion.MethodsThe clinical data of 48 patients with acute intracranial large vessel occlusion within 6 h were retrospectively analyzed, and the patients were divided into the stent thrombectomy group and bridge treatment group.The baseline data were compared between two groups.After two groups were treated for 14 d, the efficacy of two groups were analyzed using the National Institutes of Health stroke scale(NIHSS).The prognosis, adverse reactions and death of modified Rankin score(mRS) in two groups at 90 d of treatment were observed.ResultsThe results of comparison of the 14-day effective rate between two groups showed that the cumulative effective rate in two groups were high(77.78% and 85.71%), and the difference of which was not statistically significant(P>0.05).The total proportion of cured and effective rate in bridge treatment group after 14 d of treatment was higher than that in stent thrombolysis group(P < 0.05).The differences of the time from admission to vascular recanalization, times of thrombectomy, prognosis, symptomatic intracranial hemorrhage and one-month all-cause mortality between two groups were not statistically significant(P>0.05), and the good prognosis rate of 90 d in bridging group was higher than that in stent thrombectomy group(P < 0.05).ConclusionsBoth simple stent thrombectomy and intravenous thrombolysis bridging stent thrombectomy can rapidly open the intracranial occluded aorta, and the bridging group has better short-term and long-term efficacy.