| Objective To observe the clinical curative effect and security comparison of acute cerebral infarction treated by interventional artery recanalization and venous thrombolysis,explore the best treatment of acute cerebral infarction, in order to make more benefit from it.Methods Retrospectively analysis the clinical data of patients with acute cerebral infarction in our hospital from December 2010- December 2013.A total of 30 patients received venous thrombolysis treatment, as the vein group; A total of 20 patients received the interventional artery recanalization, as artery group; The gender, age, body mass, the infarction area, the thrombolysis time window, and blood pressure before thrombolysis, related laboratory tests, the degree of nerve function defect score(NIHSS) of the two groups of patients has no statistically significant difference, the two group were comparable. The artery group received the joint application of interventional artery thrombolysis, mechanical bolt, stent implantation, balloon expansion forming. The vein group received venous thrombolysis treatment using the recombinant tissue plasminogen activator(rt-PA). To exclusion of patients with intracranial bleeding tendency, both groups received the dehydration, anti-platelet aggregation, improve circulation and protect neurons and other conventional treatment 24 h after treatment. Clinical curative effect evaluation method: Observe and compare the NIHSS score of the two groups 2h, 24 h, 3d, 7d, 14 d after treatment; Observe and compare the the modified Rankin scale(MRS) of two groups 3 months and 6 months after treatment; Statistics the blood vessel recanalization situation by the imaging data before and after treatment. The safety evaluation methods: to observe the incidence of bleeding complications and mortality.Results The NIHSS score of the two groups before treatment had no statistical significance(t=1.038,P>0.05); The NIHSS score of the two groups 2 h, 24 h, 3 d, 7 d and 14 d after treatment was significantly decreased than before treatment, the difference has statistically significant(P<0.05 or P<0.01), but the NIHSS score improvement of artery group was obviously better than that of the vein group, the difference has statistically significant(P<0.05 or P<0.01). The significant efficiency of the artery group 14 d after treatment was obviously higher than that of vein group(X2=3.904,P<0.05), but the total effective rate of the two groups has no statistically significant difference(X2=1.205,P>0.05).The MRS score of artery group 3 months and 6 months after treatment was obviously better than that of the vein group, the difference has statistically significant t=2.034ã€2.336,P<0.05). Vascular occlusion of internal carotid artery system of the artery group was 14 cases(70.0%), blood vessel recanalization in 4 cases, partial recanalization 7 cases, not recanalization in 2 cases, recanalization rate is 78.6%;Vascular occlusion of vertebral-basilar artery system was 6 cases(30.0%), blood vessel recanalization in 3 patients, partial recanalization in 2 cases, not recanalization in 1 case, the recanalization rate of 83.3%. Security: 2 cases(10%) of patients of artery group happened intracranial hemorrhage, 1 case(5%) of patients happened puncture hematoma, 1 case(5%) of patients happened gastrointestinal bleeding, 1 case(5%) of patients happened urinary tract bleeding. 3 cases(10%) of patients of vein group happened intracranial hemorrhage, 1 case(3.3%) of patients happened gingival bleeding, 3 cases(10%) of patients happened upper gastrointestinal bleeding.Bleeding incidence of the two groups has no statistically significant difference(X2=1.203, P>0.05). The fatality rate of artery and vein group respectively was 3 cases(15%) and 4 cases(13.3%), there was no statistically significant difference(X2=1.045, P>0.05).Conclusion The clinical curative effect of interventional artery recanalization and venous thrombolysis treatment was good and has high safety. But the significant efficiency of interventional artery recanalization was significantly better than intravenous thrombolysis. The degree of the dependence on daily life activities and invalidism of patients with acute cerebral infarction treated by interventional artery recanalization was significantly lower than the patients treated by venous thrombolysis. |
