急性脑梗死行机械支架介入取栓联合静脉溶栓的效果分析

目的 分析急性脑梗死（ACI）行机械支架介入取栓联合静脉溶栓的效果。方法 回顾性分析2020年1月至2021年4月于河北中石油中心医院治疗的116例ACI病人的临床资料，利用SPSS 19.0软件对病人实施1∶1倾向性评分匹配（PSM），最终将行阿替普酶静脉溶栓治疗（溶栓组，n=47）及在其基础上实施机械支架介入取栓（联合组，n=48）的病人作为研究对象。比较两组疗效、即刻血管再通率、神经功能、脑血流动力学指标、氧化应激指标超氧化物歧化酶（SOD）、丙二醛]、阿替普酶用量、并发症发生率及预后情况。结果 联合组即刻血管再通率、治疗1个月后总有效率分别为91.67%(44/48)、93.75%(45/48)，明显较溶栓组的72.34%(34/47)、76.60%(36/47)高（P<0.05）；治疗后两组CSS评分及血清丙二醛水平和治疗前相比均明显降低（P<0.05），且联合组均明显较溶栓组低（均P<0.05）；治疗后1个月两组血清SOD水平和治疗前相比均明显升高（均P<0.05），且联合组均明显较溶栓组高（P<0.05）；治疗后1个月两组发病部位位于大脑半...

Analysis of the effect of mechanical stent interventional thrombectomy combined with intravenous thrombolysis on acute cerebral infarction

Objective To analyze the effect of mechanical stent interventional thrombectomy combined with intravenous thromboly?sis in acute cerebral infarction (ACI).Methods The clinical data of 116 patients with ACI treated in Hebei CNPC Central Hospital from January 2020 to April 2021 were retrospectively analyzed. The patients were matched with 1:1 propensity score (PSM) by SPSS 19.0 software. Finally, the patients who underwent intravenous thrombolytic therapy with alteplase (thrombolytic group, n=47) and me?chanical stent interventional thrombectomy (combined group, n=48) were taken as the research objects. The curative effect, immediate vascular recanalization rate, neurological function, cerebral hemodynamic indexes, oxidative stress indexes superoxide dismutase(SOD), malondialdehyde], alteplase dosage, complication rate and prognosis of the two groups were compared.Results The immediate vascular recanalization rate and the total effective rate after one month of treatment in the combined group were 91.67% (44/48) and 93.75% (45/48) respectively, which were significantly higher than 72.34% (34/47) and 76.60% (36/47) in the thrombolytic group (P<0.05); after treatment, the CSS scores and serum malondialdehyde levels of the two groups were significantly lower than those of before treatment (P<0.05), and the combined group were significantly lower than the thrombolysis group (all P<0.05); one month after treat?ment, the serum SOD levels in the two groups were significantly higher than those before treatment in the same group (all P<0.05), and the combined group were significantly higher than the thrombolysis group (P<0.05); One month after treatment, the maximum peak flow velocity (VS), vascular resistance index (RI) of middle cerebral artery in patients with cerebral hemisphere, the bilateral vertebral artery (VA) and basilar artery (BA) in patients with brainstem and cerebellum were significantly improved compared with those before treat?ment (P<0.05), and the improvement in the combined group was significantly better than that in the thrombolytic group (P<0.05); the dosage of alteplase in the combined group was significantly less than that in the thrombolytic group (P<0.05); after treatment, the inci?dence of complications in the combined group was significantly lower than that in the thrombolytic group (P<0.05); 3 months after treat?ment, the GOS grade of the combined group was significantly better than that of the thrombolytic group (P<0.05).Conclusion The ef?fect of mechanical stent intervention combined with intravenous thrombolysis with alteplase in patients with ACI is better, which can significantly improve the index of oxidative stress and cerebral hemodynamics, significantly reduce the degree of neurological deficit, ef?fectively reduce the occurrence of complications, and help patients obtain ideal prognosis.