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【摘要】 目的：探究急性重症缺血性卒中患者经动脉内溶栓联合血管成形术治疗后的临床效果。方法：选择2013年6月-2015年6月两年间本院治疗的重症缺血性卒中患者100例，根据治疗方式的不同将其均分为对照组和探究组，每组50例。对照组采用动脉内溶栓治疗，探究组在对照组的基础上联合血管成形术治疗，对比分析两组患者治疗前后的NIHSS、mRS评分，治疗结果、预后情况及并发症发生情况。结果：两组治疗后的NIHSS、mRS评分结果均明显低于治疗前，且探究组患者的NIHSS、mRS评分均明显低于对照组，差异均有统计学意义（P<0.05）。探究组患者治疗后的血管完全再通率及预后良好率分别为94.00%、66.00%，均显著高于对照组的68.00%、40.00%，差异均有统计学意义（P<0.05）。探究组的并发症发生率20.00%明显低于对照组的46.00%，差异有统计学意义（ 字2=7.644，P=0.006）。结论：动脉内溶栓和血管成形术联合治疗可以提高急性重症缺血性卒中患者的预后质量，降低患者的痛苦，具有显著的临床应用价值。
【关键词】 缺血性卒中； 动脉内溶栓； 血管成形术
【Abstract】 Objective：To explore the clinical efficacy of arterial thrombolysis combined with angioplasty for the treatment of acute severe ischemic stroke patients.Method：100 patients with acute severe ischemic stroke admitted to our hospital from June 2013 to June 2015 were selected and randomly divided into the control group and the research group according to the treatment type，50 cases in each group.The control group was treated with arterial thrombolysis，the research group was treated with arterial thrombolysis combined with angioplasty.The NIHSS score and mRS score before treatment and after treatment，clinical efficacy，prognosis and complications between the two groups were compared and analyzed.Result：The NIHSS and mRS scores of the two groups after treatment were significantly lower than before treatment，and the NIHSS and mRS scores of the research group were significantly lower than the control group，the differences were statistically significant（P<0.05）.After treatment，the vascular complete recanalization rate and prognosis good rate of the research group were 94.00% and 66.00% respectively，which were significantly higher than 68.00% and 40.00% of the control group，the differences were statistically significant（P<0.05）.The complications incidence of the research group was 20.00%，which was significantly lower than 46.00% of the control group，the difference was statistically significant（ 字2=7.644，P=0.006）.Conclusion：Arterial thrombolysis combined with angioplasty can improve the prognosis quality of patients with severe acute ischemic stroke，can reduce the suffering of patients，so it has significant clinical value.
【Key words】 Ischemic stroke； Intra-arterial thrombolysis； Angioplasty
First-author’s address：The First People’s Hospital of Huizhou City，Huizhou 516000，China
doi：10.3969/j.issn.1674-4985.2016.05.039
大量的研究结果证实，颅内大动脉闭塞是导致患者出现急性重症缺血性卒中的主要原因[1-2]。脑卒中的危害十分严重，常给患者带来较为严重的运动、感觉、认知、言语、心理障碍，严重影响着患者的生活质量。患者静脉及动脉溶栓是一种临床常用的早期血管再通手段，经过治疗后患者的病情显著好转。除此之外，血管内机械再通也可以实现良好的效果，而且可以缩短治疗时间，提升再通率，因此临床效果显著。目前，球囊扩张术或支架置入术是较为常用的两种有效弥补单纯动脉溶栓治疗弊端的手段[3-4]。本次为探究经动脉内溶栓联合血管成形术治疗后的临床效果，特选取100例患者的临床资料加以回顾分析，现将结果具体报告如下。
【关键词】 缺血性卒中； 动脉内溶栓； 血管成形术
【Abstract】 Objective：To explore the clinical efficacy of arterial thrombolysis combined with angioplasty for the treatment of acute severe ischemic stroke patients.Method：100 patients with acute severe ischemic stroke admitted to our hospital from June 2013 to June 2015 were selected and randomly divided into the control group and the research group according to the treatment type，50 cases in each group.The control group was treated with arterial thrombolysis，the research group was treated with arterial thrombolysis combined with angioplasty.The NIHSS score and mRS score before treatment and after treatment，clinical efficacy，prognosis and complications between the two groups were compared and analyzed.Result：The NIHSS and mRS scores of the two groups after treatment were significantly lower than before treatment，and the NIHSS and mRS scores of the research group were significantly lower than the control group，the differences were statistically significant（P<0.05）.After treatment，the vascular complete recanalization rate and prognosis good rate of the research group were 94.00% and 66.00% respectively，which were significantly higher than 68.00% and 40.00% of the control group，the differences were statistically significant（P<0.05）.The complications incidence of the research group was 20.00%，which was significantly lower than 46.00% of the control group，the difference was statistically significant（ 字2=7.644，P=0.006）.Conclusion：Arterial thrombolysis combined with angioplasty can improve the prognosis quality of patients with severe acute ischemic stroke，can reduce the suffering of patients，so it has significant clinical value.
【Key words】 Ischemic stroke； Intra-arterial thrombolysis； Angioplasty
First-author’s address：The First People’s Hospital of Huizhou City，Huizhou 516000，China
doi：10.3969/j.issn.1674-4985.2016.05.039
大量的研究结果证实，颅内大动脉闭塞是导致患者出现急性重症缺血性卒中的主要原因[1-2]。脑卒中的危害十分严重，常给患者带来较为严重的运动、感觉、认知、言语、心理障碍，严重影响着患者的生活质量。患者静脉及动脉溶栓是一种临床常用的早期血管再通手段，经过治疗后患者的病情显著好转。除此之外，血管内机械再通也可以实现良好的效果，而且可以缩短治疗时间，提升再通率，因此临床效果显著。目前，球囊扩张术或支架置入术是较为常用的两种有效弥补单纯动脉溶栓治疗弊端的手段[3-4]。本次为探究经动脉内溶栓联合血管成形术治疗后的临床效果，特选取100例患者的临床资料加以回顾分析，现将结果具体报告如下。