动静脉溶栓联合动脉成形术治疗老年急性脑梗死患者的临床观察

目的探讨接受动静脉溶栓联合动脉成形术治疗急性脑梗死患者的临床疗效。方法选择急性脑梗死患者238例,根据治疗方法不同分为3组,动静脉溶栓联合动脉成形术组(治疗组)34例,动脉溶栓组92例,静脉溶栓组112例。从血管再通、欧洲脑卒中量表(European Stroke Scale,ESS)评分、Ba rthel指数评分以及脑出血病死率4个方面比较3组临床疗效。结果治疗组、动脉溶栓组和静脉溶栓组患者24 h内ESS评分分别为(93.7±6.3)分,(79.2±20.8)分和(74.1±35.9)分。3组患者第30天临床治愈率、总有效率分别为88.2%和94.1%,79.3%和90.2%,55.4%和71.4%。动脉溶栓组和静脉溶栓组患者24 h内ESS评分较治疗组明显下降,差异有统计学意义(P0.01)。结论动静脉溶栓联合动脉成形术可在最短时间内使血管再通,再通率高,早期和远期神经功能评价高,且脑出血的发生率低,是治疗急性脑梗死的安全有效方法 。

Clinical observation of arteriovenous thrombolysis combined with arterioplasty for treating ACI in old patients

Objective To investigate the clinical efficacy of arteriovenous thrombolysis combined with arterioplasty for treatment of acute cerebral infarction (ACI) in old patients.Methods 238 cases of ACI were selected.According to the different treatment methods they were divided into three groups;combined arteriovenous thrombolysis therapy and arterioplasty group (treatment group) 34 patients,intra-arterial thrombolysis therapy(intra-arterial) group 92 cases and intravenous thrombolysis therapy(intra-venous) group 112 cases.The clinical efficacy in revascularization, European Stroke Scale(ESS) score,Barthel index score,the incidence of cerebral hemorrhage and fatality of the three groups were observed and compared.Results ESS scores of treatment group,intra-arterial group and intra-venous group were 93.7 ± 6.3,79.2 ± 20.8 and 74.1 ± 35.9 respectively in 24 h.The clinical cure rates and overall effective rates after 30 days were 88.2% and 94.1% in treatment group;79.3% and 90.2% in intra-arterial groups 55.4% and 71.4% in intra-venous group.The ESS scores of intra-arterial group and intra-venous group in 24 h were significantly lower compared with treatment group (P < 0.01).Conclusion Arteriovenous thrombolytic therapy combined with arterioplasty can make revascularization quickly,and high recanalization rate,high early and long-term neurological function score,and reduce the incidence of cerebral hemorrhage.At the same time,it is the safe and effective method for treating acute cerebral infarction.