Clinical Analysis Of Different Treatment Regimens For Acute Ischemic Stroke With Atrial Fibrillation

Research background and purpose:Atrial fibrillation is one of the most common arrhythmias,which can lead to serious complications such as heart failure,acute ischemic stroke(AIS),and even death.Among them,the treatment methods that can be used in the early stage of AIS are intravenous thrombolysis,bridging arterial thrombectomy,intravascular mechanical thrombectomy,etc.,but for the prognosis of different treatment methods,domestic and foreign reports have different opinions,and there is no accompanying Patients with AIS of AF were compared according to their clinical symptoms and vascular occlusion.In this study,a detailed retrospective analysis and summary of different ultra-early treatments and prognosis of AIS patients with AF in the past 3 years was conducted to explore the best prevention and treatment strategies for AIS patients with AF,and to select treatment options for clinicians.for reference.Methods:The data of 96 AF-related stroke patients in the past 3 years were retrospectively collected.According to their treatment methods,they were divided into the intravenous thrombolytic therapy group,the bridged arterial thrombectomy group,and the intravascular mechanical thrombectomy group.Among them,the components of intravenous thrombolytic therapy were 3 subgroups: NHISS score ≥8 group without responsibility for large vessel occlusion;NHISS score <8 for non-responsible macrovascular occlusion;NHISS score ≥ 8 for responsible large vessel occlusion.Finally,the treatment effects were evaluated according to changes in NHISS scores,modified Rankin scale(m RS)scores,intracranial hemorrhage conversion rate,symptomatic cerebral hemorrhage(s ICH),and mortality.Result :(1)For patients with AIS who were not responsible for large vessel occlusion and with AF,no significant difference in the prognosis between the two groups was achieved by intravenous thrombolysis with NHISS score <8 or ≧8.Significance(P>0.05).(2)For patients with AIS who were in the unrestrained large vessel occlusion group and the responsible large vessel occlusion group,the NHISS scores were 8 points.After intravenous thrombolysis in both groups,the short-term neurological function recovery and long-term prognosis of the former were both.Compared with the latter,the difference was statistically significant(P<0.05);the former intracranial hemorrhage conversion rate and mortality were lower than the latter,the difference was statistically significant(P<0.05).(3)For patients with responsible large vessel occlusion,the intravascular mechanical thrombectomy group compared with the intravenous thrombolytic therapy group,the former short-term neurological recovery,long-term prognosis and recanalization rate were better than the latter,the difference is Statistical significance(P<0.05);the former intracranial hemorrhage conversion rate,mortality was lower than the latter,the difference was statistically significant(P<0.05).(4)For patients with responsible large vessel occlusion,the short-term neurological recovery,long-term prognosis,and recanalization rate of the former were better than those of the intravenous thrombolysis group.The difference was statistically significant(P <0.05).There was no significant difference in the conversion rate of intracranial hemorrhage,the proportion of symptomatic cerebral hemorrhage and mortality in the two groups,and the difference was not statistically significant(P>0.05).Conclusion:(1)Ultra-early intravenous thrombolysis for patients with AIS who have no responsibility for large vessel occlusion with AF,regardless of baseline NHISS < 8 points or baseline NHISS score ≧ 8 points,can obtain good prognosis.(2)Patients with AIS who underwent ultra-early intravenous thrombolysis with a baseline NHISS score of 分 8 with AF,and those with no responsibility for large vessel occlusion were more responsible for large vessel occlusion and had a better prognosis.(3)AIS patients with responsibility for large vessel occlusion with AF,ultra-early bridging treatment or simple intravascular mechanical thrombectomy have better prognosis than intravenous thrombolytic therapy,and intravascular mechanical thrombectomy is more intravenously Suppository treatment of intracranial hemorrhage conversion rate and mortality is lower.