|
|
|
| Comparison of application effect of mechanical thrombectomy and intra-arterial thrombolysis in patients with acute cerebral infarction |
| WANG Liming YANG Dandan CHEN Jing CAI Dandan ZHANG Xueling▲ |
| Department of Neurology, Suqian Hospital Affiliated to Xuzhou Medical University, Jiangsu Province, Suqian 223800, China |
|
|
|
|
Abstract Objective To explore the application effect of mechanical thrombectomy (MT) and intra-arterial thrombolysis (IAT) in patients with acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction admitted to Suqian Hospital Affiliated to Xuzhou Medical University from January 2021 to July 2022 were included in the study and they were divided into thrombectomy group and thrombolysis group according to different treatment methods, with 60 cases in each group. The thrombectomy group received MT and the thrombolysis group received IAT. The clinical efficacy of the two groups was recorded and compared, the vascular recirculation condition of the two groups was compared, and the levels of neurological function indicators (National Institutes of Health stroke scale [NIHSS] score, neuron specific enolase [NSE], S100β protein [S100β], brain-derived neurotrophic factor [BDNF]) before and after surgery of the two groups were measured and compared. Complications and prognosis of the two groups were recorded and compared. Results The clinical effect of thrombectomy group was better than that of thrombolysis group, and the difference was statistically significant (P＜0.05). The vascular condition of thrombectomy group was better than that of thrombolysis group, and the difference was statistically significant (P＜0.05). One week after surgery, the NIHSS score, NSE, and S100β levels of the two groups were decreased, while the BDNF level was increased, and the NIHSS score, NSE, and S100β levels of the thrombectomy group were lower than those of the thrombolysis group, while the BDNF level of the thromectomy group was higher than that of the thrombolysis group, and the differences were statistically significant (P＜0.05). The incidence of complications and mortality in thrombectomy group were lower than those in thrombolysis group, and the differences were statistically significant (P＜0.05). Conclusion The therapeutic effect of MT on patients with acute cerebral infarction is significantly better than that of IAT, which can effectively help vascular recanalization, improve postoperative neurological function of patients, and reduce complications and mortality.
|
|
|
|
|
|
[1] 王金成，姜立刚，李海平，等.急性脑梗死患者血清正五聚体蛋白3、C反应蛋白水平变化及临床意义[J].中国老年学杂志，2018，38（1）：71-73.
[2] 梁菊萍，杨旸，董继存.急性脑梗死患者流行病学调查及危险因素[J].中国老年学杂志，2021，41（12）：2484-2487.
[3] Ueta Y，Kato H，Naito M，et al. Persistent Hemichorea as a Preceding Symptom of Cerebral Infarction Due to Middle Cerebral Artery Stenosis [J]. Internal Med，2021，60（23）：3805-3808.
[4] Liu X，Rao S，Wang J. Intravenous thrombolysis in combination with mild hypothermia therapy in the treatment of acute cerebral infarction [J]. Pak J Med Sci，2019，35（4）：1161- 1166.
[5] Zeng J，Wang F，Feng H，et al. Influencing Factors of Recanalization after Intravenous Thrombolysis with Urokinase in Acute Cerebral Infarction Patients [J]. Eur Neurol，2020， 83（2）：162-166.
[6] Charbonnier G，Bonnet L，Bouamra B，et al. Does Intravenous Thrombolysis Influence the Time of Recanalization and Success of Mechanical Thrombectomy during the Acute Phase of Cerebral Infarction? [J]. Cerebrovasc Dis Extra，2020，10（1）：28-35.
[7] Akbik F，Alawieh A，Cawley CM，et al. Differential effect of mechanical thrombectomy and intravenous thrombolysis in atrial fibrillation associated stroke [J]. J Neurointerv Surg，2020，13（10）：883-888.
[8] 中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志，2018，51（9）：666-682.
[9] Heldner MR，Zubler C，Mattle HP，et al. National Institutes of Health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke [J]. Stroke，2013，44（4）：1153-1157.
[10] Raychev R， Saber H， Saver JL，et al. Impact of eloquent motor cortex-tissue reperfusion beyond the traditional thrombolysis in cerebral infarction （TICI） scoring after throm- bectomy [J]. J Neurointerv Surg，2020，13（11）：990-994.
[11] 杨超祺，陈薇，刘艳源，等.磷酸化Tau181联合血脂指标对急性脑梗死患者发生血管性痴呆的预测价值分析[J].实用心脑肺血管病杂志，2022，30（3）：43-47.
[12] 唐彦，张凡，窦艳霞，等.急性脑梗死患者血清Galectin-3、TIMP-1、CaM水平与神经功能缺损程度及预后的关系[J].山东医药，2020，60（17）：58-61.
[13] Li XS， Ma DZ，Sun GZ. Effects of Edaravone on Neurological Function and Tumor Necrosis Factor Alpha and Interleukin 8 Levels in Patients with Cerebral Infarction [J]. Eur Neurol，2020，83（1）：73-79.
[14] 杨春，徐玲玲，万春晓.急性脑梗死患者静脉溶栓前后氧化应激表达与功能结局的相关性[J].重庆医学，2022， 51（6）：910-915.
[15] 卢先富，麦用军，阳洪，等.动脉内溶栓联合高压氧对重症缺血性脑卒中患者血清CGRP、sICAM-1水平的影响[J].心血管康复医学杂志，2019，28（2）：192-196.
[16] 于丽波，王帅，姜瀛，等.尿激酶静脉溶栓与超选择性动脉溶栓治疗急性大脑中动脉脑梗死的效果[J].中国医药导报，2019，16（4）：100-103.
[17] 杨小梅，金泉伟.超早期选择动脉内溶栓与静脉内溶栓治疗急性脑梗死疗效比较[J].海南医学，2019，30（19）：2452-2455.
[18] 杨华，王硕，严明锦，等.亚低温联合动脉溶栓治疗急性脑梗死的临床应用价值[J].卒中与神经疾病，2020，27（4）：448-451.
[19] 徐英钦，张保朝.机械取栓治疗急性基底动脉闭塞患者预后的影响因素研究[J].实用心脑肺血管病杂志，2020， 28（6）：47-51.
[20] 李卓卫.动脉内机械取栓治疗急性后循环缺血性脑卒中临床效果及预后影响因素分析[J].中国医药科学，2021， 11（19）：202-205.
[21] 胡珊，郑超，何欢.动脉内机械取栓治疗缺血性脑卒中的效果及其影响因素分析[J].中国当代医药，2021，28（21）：9-12.
[22] 路昭颖，贺婵婵，李宝宝，等.急性缺血性脑卒中患者机械取栓术预后影响因素的研究进展[J].中国临床研究，2023，36（3）：375-379.
[23] 陈付文，刘金朝，康孝理，等.Solumbra技术在急性大动脉闭塞性脑梗死机械取栓中的初步应用观察[J].介入放射学杂志，2019，28（6）：515-520.
[24] 桂林英，杨军政，孟祥会，等.支架机械取栓与动脉溶栓对中重度急性脑梗死患者血管再通、神经功能及预后的影响研究[J].临床误诊误治，2019，32（1）：100-104.
[25] 张誓伟，赵杰菲，贺显君，等.急性脑梗死患者血清S100β及NSE水平与血管性痴呆的相关性研究[J].中风与神经疾病杂志，2021，38（4）：315-318.
[26] 李蓉，付华莉，王琰.急性脑梗死患者经导管选择性脑动脉内介入对MBP、TIMP1、NSE和S100β表达水平的影响[J].哈尔滨医科大学学报，2020，54（4）：392-396.
[27] 邓承能，陈志俊，李洪现.机械取栓对急性脑血管闭塞患者氧化应激及神经功能的影响研究[J].川北医学院学报，2021，36（6）：741-744.
[28] 李通，秦文军，苏达京，等.机械取栓与动静脉配合溶栓对急性脑梗死的治疗效果和预后分析[J].中国急救医学，2017，37（1）：317-318. |
|
|
|
