Objective To investigate the safety and clinical efficacy of intravenous thrombolysis (IVT)and bridging therapy(IVT combined with mechanical thrombectomy)for intracranial arterial occlusion (IAO)in acute ischemic stroke (AIS).Methods Sixty-five AIS patients with IAO between July 2016 and July 2017 were collected, 30 patients in the IVT group accepted IVT,while 35 patients in the stent retriever group undergone bridge treatment. The baseline data,24 h,7 d NIHSS,early poor prognosis and recanalization rate,as well as 90 d mRS were compared. Besides,some adverse events including intracranial hemorrhagic transformation,bleeding elsewhere, reocclusion and clinical death were contrasted at the same time. The effectiveness and safety of two treatments were evaluated.Results Compared to pretreatment,NIHSS at 24 h and 7 d after treatment were significantly decreased in two groups (all P＜0.05). Compared to IVT group,NIHSS scores at 24 h and 7 d after treatment were significantly decreased in stent retriever group (all P＜0.05). The early good prognosis rate(24 h and 7 d)in stent retriever group(51.4%,68.6%)were significantly higher than those in IVT group(26.7%,40.0%)(all P＜0.05). The recanalization rate in stent retriever group (82.9%)was significantly higher than that in IVT group(36.7%)(P＜0.05). The 90 dlong-term good prognosis rate (mRS≤2)in stent retriever group(71.4%)was significantly higher than that in IVT group (43. 3%)( P＜ 0.05 ). The rate of adverse reactions including hemorrhage,vessel reocclusion,drug allergy and mortality rate was 40.0% and 42.8% in stent retriever group and IVT group,and there was no statistical difference between the two groups (P＞0.05 ). Conclusions IVT combined with stent-based thrombectomy plays a pivotal role in the treatment of IAO in AIS. The safety of this therapy was no statistical significance compared to the IVT treatment.%目的 探讨急性颅内大动脉闭塞性脑梗死患者静脉溶栓及桥接治疗(静脉溶栓联合机械取栓)的临床疗效和安全性.方法 选取我院2016年7月至2017年7月收治的急性大血管闭塞性缺血性脑卒中患者65例,其中30例接受静脉溶栓者为溶栓组,35例接受桥接治疗者为取栓组,通过比较患者基线资料及治疗后24 h、7 d的NHISS和早期预后良好率、血管再通率、90 d的mRS评分,同时对比治疗期间的颅内出血转化、其他部位出血、血管再闭塞、临床死亡等不良事件,评估两种治疗方案的有效性和安全性.结果 与治疗前比较,两组治疗后24 h和7 d的NIHSS评分均明显降低(均P＜0.05);治疗后24 h及7 d的NIHSS评分取栓组均明显低于溶栓组(均P＜0.05);治疗后24 h、7 d的早期预后良好率取栓组(51.4%、68.6%)均明显高于溶栓组(26.7%、40.0%)(均P＜0.05);取栓组血管再通率(82.9%)明显高于静脉溶栓组(36.7%)(P＜0.05);治疗后90 d的远期预后良好率(mRS≤2)取栓组(71.4%)明显高于溶栓组(43.3%)(P＜0.05);两组不良反应包括脑出血转化、其他部位出血、血管再闭塞、药物过敏、临床死亡等发生率,溶栓组为40.0%,取栓组为42.8%,两组比较差异无统计学意义(P＞0.05).结论 桥接治疗急性缺血性大动脉性脑卒中效果较好,且安全性与静脉溶栓治疗比较差异无显著性.
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