Analysis Of The Effective Of The Thrombolysis And Intravascular Therapy In Patients With Acute Moderate And Severe Cerebaral Ischemic Stroke

Objectives: To observe the effective of endovascular treatment between intravenous thrombolysis and intravenous thrombolysis bridged endovascular thrombectomy in patients with acute moderate to severe cerebral ischemic infarction,and to study the correlation between lateral branch blood flow classification and stroke return and prognosis.Methods: 64 patients with acute moderate and severe cerebral ischemic infarction admitted between December 2015 to December 2017 at Xingtai Third Hospital were included into the study.The patients were divided into three groups according to the therapies,simple antithrombotic therapy group(SAT)?intravenous thrombolysis group(INVT)and intravenous thrombolysis bridged endovascular thrombectomy group(BEVT).We recorded the baseline characteristics(gender,age,admission blood pressure.NIHSS score,risk factors),NIHSS scores after the treatment of 24 hours,14 days and the modified Rankin Scale(mRS)score at 90 day of all the patients.At the same time,the relationship between lateral branch blood flow grading and clinical prognosis was observed in patients with intravenous thrombolysis bridged endovascular thrombectomy.Results: After simple antithrombotic therapy,the NIHSS score was dropped to 18.86±7.96,but in intravenous thrombolysis group the NIHSS score was 12.53±8.75,the difference between the two groups was statistically significant(P<0.05),while in the intravenous thrombolysis bridged endo--vascular thrombectomy,the NIHSS score was 15.00±11.14,compared with the intravenous thrombolysis,the difference was not statistically significant(P>0.05).After 14 days of simple antithrombotic therapy,the NIHSS score was dropped to 12.61±9.95,but the NIHSS score was 7.21±5.82 in intravenous thrombolysis group,the difference between the two groups was statistically significant(P<0.05),while in the intravenous thrombolysis bridged endovascular thrombectomy,the NIHSS score was 6.58±5.88,compared with the intravenous thrombolysis,the difference was not statistically significant(P>0.05).The rate of good prognosis was 28.6% in simple antithrombotic group?38.1% in intravenous thrombolysis group?68.2% in intravenous thrombolysis bridged endovascular thrombectomy,the clinical prognosis of three groups was statistically significant(P<0.05).In the group of effective bridge opening,there were 13 cases had good collateral circulation and all patients had good prognosis in 90 days(100%),and were 5 cases had bad collateral circulation,of which 1 cases(20%)had good prognosis in 90 days,the difference was significantly(P<0.05).Conclusion:1.Acute moderate to severe cerebral infarction patients within 4.5 hours,intravenous thrombolysis can improve clinical prognosis.2.Acute moderate to severe cerebral infarction patients within 4.5 hours,when considered for large vessel occlusion,intravenous thrombolysis bridged endovascular thrombectomy can increase the probability of vessel opening and improve the clinical prognosis obviously.3.The evaluation of effective lateral branch blood flow is instructive for prognostic evaluation.The evaluation of effective lateral branch blood flow is instructive for prognostic evaluation.