单纯机械取栓和联合静脉溶栓在缺血性卒中中的疗效对比的荟萃分析

发布时间：2018-08-30 14:48

【摘要】：目的:急性缺血性脑卒中是常见的脑血管病,发病率日益增多。静脉溶栓和机械取栓为常见的有效治疗方法。但关于单纯机械取栓和机械取栓联合静脉溶栓在治疗大血管闭塞性急性卒中中的疗效及安全性对比存在争议。本荟萃分析旨在对比上述两种方法在治疗治疗大血管闭塞性急性卒中中的疗效及安全性。方法:从数据库(Pubmed,Google schalor,Cochrane library,clinicaltrial,中国知网)中搜索符合纳入排除标准的文章,并对文章进行质量评价,根据质量评价结果采用固定效应模型进行meta分析。结果:共6篇文章纳入研究,共692个病人予以机械取栓联合静脉溶栓,244个病人予以单纯机械取栓治疗。上述两种治疗方法的死亡率(OR=0.70,95%CI 0.49-0.98,P=0.04)有统计学差异,而再通率(OR=0.86,95%CI 0.56-1.33,P=0.51);症状性脑出血率(OR=0.94,95%CI 0.48-1.85,P=0.87);3个月后m RS(0-2)的比率(OR=0.93,95%CI 0.69-1.27,P=0.66)无显著差异。结论:机械取栓前进行静脉溶栓预处理可降低大血管闭塞性急性卒中在三个月内的死亡率。而单纯机械取栓和机械取栓联合静脉溶栓的再通率、脑出血率、3个月后m RS(0-2)比率无显著差异。但由于本研究纳入患者数量较少,为非随机对照研究,故仍需要大样本前瞻性随机对照研究加以验证。
[Abstract]:Objective: acute ischemic stroke is a common cerebrovascular disease with increasing incidence. Intravenous thrombolysis and mechanical thrombolysis are common effective treatment methods. However, the efficacy and safety of mechanical and mechanical thrombolysis combined with intravenous thrombolysis in the treatment of acute stroke caused by macrovascular occlusion are controversial. The purpose of this meta-analysis is to compare the efficacy and safety of these two methods in the treatment of large-vessel occlusive acute stroke. Methods: the articles that met the exclusion criteria were searched from the database (Pubmed,Google schalor,Cochrane library,clinicaltrial, China knowledge Network), and the quality of the articles was evaluated. According to the results of the quality evaluation, the fixed effect model was used for meta analysis. Results: 692 patients were treated with mechanical thrombolysis combined with intravenous thrombolysis, and 244 patients were treated with mechanical thrombolysis. The mortality rate (OR=0.70,95%CI 0.49-0.98) was significantly different between the two treatments (OR=0.86,95%CI 0.56-1.33 P0.51), symptomatic intracerebral hemorrhage (OR=0.94,95%CI 0.48-1.85 P0.87) and m RS (0-2 (OR=0.93,95%CI 0.69-1.27P0.66). Conclusion: intravenous thrombolytic preconditioning before mechanical thrombolysis can reduce the mortality of acute stroke of macrovascular occlusion within 3 months. However, there was no significant difference between mechanical thrombolysis and mechanical thrombolysis combined with intravenous thrombolytic reopening rate, intracerebral hemorrhage rate and m RS (0-2 ratio 3 months later. However, due to the small number of patients included in this study, which is a non-randomized controlled study, it still needs to be verified by a large sample of prospective randomized controlled trials.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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