Clinical Study of Intravenous Thrombolysis Combined with Stent Interventional Thrombectomy in the Treatment of Ischemic Stroke
Objective:To investigate the clinical efficacy of intravenous thrombolysis combined with stent interventional thrombectomy in the treatment of ischemic stroke(IS).Methods:A total of 94 IS patients treated in a hospital from July 2020 to June 2023 were selected and assigned to the control group and combination group by random number table method,with 47 patients in each group.Conventional treatment was provided in both groups,including oxygen inhalation,anti-infection,reducing intracranial pressure,protecting cerebral nerves,etc.Patients in the control group additionally underwent stent interventional thrombectomy,and those in the combination group additionally underwent intravenous thrombolysis with the treatment given in the control group.The vascular recanalization,vascular growth related factors[vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)],nerve injury factors[central nervous system specific protein β(S100β),glutamate and platelet-derived growth factor(PDGF)],cerebrovascular reserve function indicators[middle cerebral artery pulsatility index(MCA-PI),middle cerebral artery flow velocity,cerebrovascular reserve capacity(CVRC)],quality of life[Barthel index(BI)],neurological function[National Institutes of Health Stroke Scale(NIHSS)],quality of living[modified Rankin scale(mRS)]and adverse reactions were compared between the two groups.Results:After treatment,the recanalization rate in the combination group(91.49%)was higher than that in the control group(72.34%,P<0.05).The serum levels of VEGF and MMP-9 in both groups were significantly decreased(P<0.05),and were lower in the combination group as compared with the control group(P<0.05).The serum levels of S100β,glutamate and PDGF in both groups were decreased(P<0.05),and were lower in the combination group as compared with the control group(P<0.05).The levels of middle cerebral artery flow velocity and CVRC were increased in both groups(P<0.05),and were higher in the combination group as compared with the control group(P<0.05).The MCA-PI in both groups was decreased(P<0.05),and was lower in the combination group as compared with the control group(P<0.05).The BI score in both groups was increased(P<0.05),and was higher in the combination group as compared with the control group(P<0.05).The scores of NIHSS and mRS in both groups were decreased(P<0.05),and were lower in the combination group as compared with the control group(P<0.05).No serious adverse reactions occurred in either group.Conclusion:Intravenous thrombolysis combined with stent interventional thrombectomy in the treatment of IS can effectively improve the recanalization rate,reduce the levels of vascular growth related factors and nerve injury factors,enhance the cerebrovascular reserve capacity,improve the neurological function and quality of life,and improve the quality of living,with a high safety profile.
万方数据
维普
