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目的观察在急性缺血性脑卒中患者中应用动静脉联合血管再通治疗的疗效和安全性。方法对2011年11月至2014年12月收治的急性缺血性脑卒中[美国国立卫生研究院卒中量表(NIHSS)评分≥10分]83例患者进行回顾性分析。将单纯静脉溶栓治疗的62例患者归为溶栓组;将静脉溶栓后无好转再行动脉内支架取栓治疗的21例患者归为取栓组。对两组进行疗效和安全性比较:1治疗7 d时比较两组NIHSS及改良Rankin(m RS)评分;2比较治疗后24 h的出血转化率和治疗后7 d的病死率。结果溶栓组和取栓组基线特征除高血压病史外余均差异无统计学意义(P﹥0.05)。两组疗效比较,治疗后7 d,NIHSS评分和m RS评分均差异无统计学意义(P﹥0.05)。两组安全性比较,治疗后24 h头颅CT显示出血转化率差异无统计学意义(P﹥0.05),两组治疗后7 d的病死率差异无统计学意义(P﹥0.05)。结论动脉取栓治疗的安全性与静脉溶栓治疗比较差异无显著性,且疗效未见比静脉溶栓治疗更好,可能与取栓治疗时间存在延误有关。
Objective To observe the efficacy and safety of arteriovenous plus revascularization in patients with acute ischemic stroke. Methods A retrospective analysis of 83 patients with acute ischemic stroke [NIH Stroke Scale (NIHSS) score ≥10) admitted from November 2011 to December 2014 was performed. Sixty-two patients treated with simple intravenous thrombolysis were classified as thrombolytic group. Twenty-one patients without thrombolysis after intravenous thrombolysis and thrombolysis with arterial stent were classified as thrombectomy group. The efficacy and safety of the two groups were compared: 1 The NIHSS and modified Rankin (m RS) scores were compared between the two groups on the 7th day of treatment; 2 The hemorrhagic conversion rate at 24 hours and the mortality after 7 days of treatment were compared. Results There was no significant difference in the baseline characteristics of thrombolysis group and embolectomy group except for the history of hypertension (P> 0.05). There was no significant difference in NIHSS score and mRS score between the two groups after 7 days of treatment (P> 0.05). There was no significant difference in the rate of hemorrhage between the two groups (P> 0.05). There was no significant difference in mortality rate between the two groups at 7 days (P> 0.05). Conclusions The safety of arterial embolectomy is not different from that of intravenous thrombolytic therapy, and the curative effect is better than that of intravenous thrombolytic therapy, which may be related to the delay of thrombectomy treatment.