动脉溶栓联合介入治疗老年急性脑血管闭塞的临床效果及安全性

发布时间：2018-12-20 11:57

【摘要】：目的探讨动脉溶栓联合介入方法治疗老年急性脑血管闭塞的临床效果及安全性。方法 97例老年急性脑血管闭塞患者均采用微导丝、微导管机械碎栓和(或)Solitaire支架联合动脉注射重组人组织型纤溶酶原激活物(rt-PA)进行治疗,分析其治疗效果及手术并发症。结果46例大脑中动脉主干闭塞的患者有35例达到完全再通、11例达到部分再通,再通率为100%;22例颈内动脉末端分叉处闭塞的患者有9例达到完全再通、6例达到部分再通,再通率为68.18%;11例大脑前动脉闭塞的患者有11例达到完全再通,再通率为100%;18例椎基底动脉主干闭塞的患者有4例达到完全再通、7例达到部分再通,再通率为61.11%;97例急性脑血管闭塞患者的再通率为85.57%。大脑中动脉主干闭塞及大脑前动脉闭塞患者的再通率显著高于颈内动脉末端分叉处闭塞和椎基底动脉主干闭塞的患者(P0.05)。97例急性脑血管闭塞的患者在术后1 w、2 w及3个月的美国国立卫生研究院卒中量表(NIHSS)平均评分较治疗前显著降低(P0.05),日常生活能力评分量表(ADL)平均评分较治疗前显著的提高(P0.05)。结论动脉溶栓联合介入方法治疗老年急性脑血管闭塞安全有效,尤其对大脑中动脉主干闭塞及大脑前动脉闭塞患者具有较好的再通效果。
[Abstract]:Objective to investigate the clinical effect and safety of thrombolytic therapy combined with interventional therapy in elderly patients with acute cerebral vascular occlusion. Methods 97 elderly patients with acute cerebrovascular occlusion were treated with microconductive wire, microcatheter mechanical thrombus breakage and / or Solitaire stents combined with arterial injection of recombinant human tissue plasminogen activator (rt-PA). The therapeutic effect and operative complications were analyzed. Results among 46 patients with middle cerebral artery occlusion, 35 patients had complete recanalization, 11 patients had partial recanalization, and the recanalization rate was 100. Of the 22 patients with occlusion at the end of the internal carotid artery, 9 had complete recanalization and 6 had partial recanalization. The recanalization rate of 11 patients with anterior cerebral artery occlusion was 68.18. 11 patients achieved complete recanalization, and the recanalization rate was 100. Of the 18 patients with vertebrobasilar artery occlusion, 4 had complete recanalization, and 7 had partial recanalization. The recanalization rate was 85.57 in 97 patients with acute cerebrovascular occlusion. The recanalization rate of middle cerebral artery occlusion and anterior cerebral artery occlusion was significantly higher than that of internal carotid artery end bifurcation occlusion and vertebrobasilar artery occlusion (P0.05). After 2 weeks and 3 months, the average (NIHSS) score of the stroke scale of the National Institutes of Health was significantly lower than that before treatment (P0.05), and the average (ADL) score of the ADL scale was significantly higher than that before treatment (P0.05). Conclusion the combination of thrombolytic therapy and interventional therapy is safe and effective in the treatment of acute cerebral vascular occlusion in elderly patients, especially in patients with middle cerebral artery occlusion and anterior cerebral artery occlusion.
【作者单位】：邢台市人民医院神经内科;
【分类号】：R743.3

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