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目的观察微导管机械碎栓联合支架取栓治疗脑梗死>24 h患者的临床效果。方法选取2015年5月—2016年5月连云港市灌南县第一人民医院收治的脑梗死>24 h患者150例,根据治疗方法分为对照组68例和观察组82例。对照组患者行支架取栓术,观察组患者行微导管机械碎栓联合支架取栓术。比较两组患者治疗后24 h、7 d有效率,治疗前及治疗后24 h、7 d美国国立卫生研究院卒中量表(NIHSS)评分,治疗后3个月改良Rankin量表(mRS)评分,血管再通率及术后并发症发生率。结果观察组患者治疗后24 h、7 d有效率均高于对照组(P<0.05)。两组患者治疗前NIHSS评分比较,差异无统计学意义(P>0.05);观察组患者治疗后24 h、7 d NIHSS评分均低于对照组(P<0.05)。观察组患者治疗后3个月mRS评分低于对照组(P<0.05)。观察组患者血管再通率高于对照组(P<0.05)。观察组患者术后并发症发生率低于对照组(P<0.05)。结论微导管机械碎栓联合支架取栓治疗脑梗死>24 h患者安全有效。
Objective To observe the clinical effect of mechanical catheter thrombolysis combined with stent thrombectomy for patients with cerebral infarction> 24 h. Methods From May 2015 to May 2016, 150 cases of patients with cerebral infarction> 24 h admitted to First People’s Hospital of Guannan County, Lianyungang City were divided into control group (n = 68) and observation group (n = 82) according to the method of treatment. Patients in the control group underwent stent thrombectomy. Patients in the observation group underwent mechanical thrombectomy combined with stent thrombectomy. The effective rate of 24 h and 7 d after treatment was compared between the two groups before treatment and at 24 h and 7 d after treatment. NIH Stroke Scale (NIHSS) score, mRS score at 3 months after treatment , Recanalization rate and postoperative complication rate. Results The effective rate of observation group at 24 h and 7 d after treatment was higher than that of control group (P <0.05). There was no significant difference in NIHSS score between the two groups before treatment (P> 0.05). The NIHSS scores of the observation group at 24 h and 7 d after treatment were both lower than those of the control group (P <0.05). The mRS score of observation group at 3 months after treatment was lower than that of control group (P <0.05). The vascular recanalization rate in observation group was higher than that in control group (P <0.05). The incidence of postoperative complications in observation group was lower than that in control group (P <0.05). Conclusion It is safe and effective to treat the patients with cerebral infarction> 24 h by using microtubule mechanical disruption combined with stent thrombolysis.