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目的 本文旨在探索单纯支架取栓治疗对于存在静脉溶栓禁忌的急性缺血性脑卒中患者的应用价值.方法 选取2016年1月至2017年1月在山西省人民医院,太原市中心医院及解放军264医院就诊的急性缺血性脑卒中患者,纳入标准包括大动脉闭塞,存在静脉溶栓禁忌,发病时间在6h内等,给予支架取栓治疗或药物治疗,治疗前后给予神经科量表评定,包括改良Rankin量表(mRS),美国国立卫生研究院卒中量表(NIHSS),对治疗前后相关量表评分及治疗后血管再通率、并发症、病死率、症状性颅内出血率等进行分析.结果 本研究共纳入了43例患者,其中23例患者接受了支架取栓治疗,20例患者接受了常规药物治疗.相对于常规药物治疗组,取栓组患者更年轻(59±13)岁和(69±12)岁,P=0.009,女性更多(65％和30％,P=0.021).治疗后72 h平均NIHSS评分,取栓组为10(7,15.5),低于常规药物治疗组(P=0.043),也低于取栓组治疗前评分(P<0.01).取栓组中患者治疗后90 d mRS评分0～2级的率更高(48％和5％,P=0.002),血管再通率(脑梗死溶栓系统等级评分2b/3级)明显升高(87％和5％,P=0.001).2组患者在病死率(9％和15％,P=0.52)和症状性颅内出血率(0和15％,P=0.054)上差异无统计学意义.结论 对大动脉闭塞且有静脉溶栓禁忌的患者进行支架取栓治疗,可改善患者3 d内的NIHSS评分,改善患者90 d的mRS评分,但不能降低患者90d的病死率和症状性颅内出血率.“,”Objective To investigate the value of simple stent retriever thrombectomy in patients with acute is-chemic stroke contraindicated for intravenous thrombolysis. Methods Included in this study were acute ischemic stroke patients who visited Shanxi Provincial People′s Hospital, Taiyuan City Central Hospital and People′s Libera-tion Army No. 264 Hospital between January 2016 and January 2017. The inclusion criteria were: major artery occlu-sion, presence of indications against intravenous thrombolysis, and an onset time of<6 h. The patients were given stent retriever thrombectomy or conventional medications. Before and after treatment, neurological scale assessment were evaluated using the modified Rankin scale (mRS), the National Institute of Health Stroke Scale (NIHSS). Re-canalization success, complications, mortality, and symptomatic intracranial hemorrhages were determined. Results A total of 43 patients were enrolled in this study, of which, 23 patients underwent stent retriever thrombectomy and 20 received conventional medications. More patients in the thrombectomy group were young (59±13 vs 69±12, P=0.009) and female (65％ vs 30％, P=0.021) compared with those in the conventional medication group. The mean NIHSS score at 72 h after treatment was 10 (7,15.5) in the thrombectomy group, which was lower than that in the conventional medication group (P=0.043) and also lower than baseline in the same group (P<0.01). Patients in the thrombectomy group had a significantly higher rate of mRS score 0-2 at 90 days (48％ vs 5％, P=0.002) and a sig-nificantly higher revascularization rate (as reflected by thrombolysis in cerebral infarction grade 2b/3) (87％ vs 5％, P=0.001). There were no significant differences between the two groups in mortality (9％ vs 15％, P=0.52) and symptomatic intracranial hemorrhage (0 vs 15％, P=0.054). Conclusion Stent retriever thrombectomy in patients with major artery occlusion but contraindicated for intravenous thrombolysis may improve the 3-day NIHSS score and 90-day mRS score, but may not reduce the 90-day mortality and symptomatic intracranial hemorrhage.