作者：李世超，郭志勇，刘春林，徐祥辉，赵爽，谭西英，陈惠云，王耀华，谢悦

单位：

新乡医学院附属人民医院神经内科一病区

单位（英文）：

Neurology Department, Ward 1, People's Hospital Affiliated to Xinxiang Medical University, Xinxiang 453000, China

关键词：

卒中; 后循环急性缺血性脑卒中; 血管内治疗; 静脉溶栓; 治疗结果; 安全性;

关键词（英文）：

Stroke; Posterior circulation acute ischemic stroke; Endovascular treatment; Intravenous thrombolysis;Treatment outcome; Safety

中图分类号：

DOI：

10.12114/j.issn.1008-5971.2023.00.074

基金项目：

河南省医学科技攻关计划项目（LHGJ20220985）； 新乡市科技攻关计划项目（GG2020047）；

摘要：

目的 对比分析血管内治疗（EVT）与静脉溶栓（IVT）治疗后循环急性缺血性脑卒中（AIS）的早期疗效及安全性。方法 选取2018年1月至2022年5月于新乡医学院附属人民医院接受EVT或IVT的后循环AIS患者147例为研究对象。根据治疗方法将患者分为EVT组（n=45）和IVT组（n=102）。比较两组一般资料、早期预后指标（治疗后90 d功能预后良好者占比、治疗后90 d内死亡率）、安全性指标（治疗24 h内症状性颅内出血发生率）。结果 IVT组治疗后90 d功能预后良好者占比为27.5%(28/102)，低于EVT组的48.9%(22/45)(P<0.05)。IVT组与EVT组治疗后90 d内死亡率比较，差异无统计学意义（P>0.05）。IVT组与EVT组治疗24 h内症状性颅内出血发生率比较，差异无统计学意义（P>0.05）。结论 EVT治疗后循环AIS的早期功能疗效优于IVT，但二者的早期死亡率及症状性颅内出血发生率相似，在临床实践过程中，如后循环AIS患者符合EVT的适应证，则可首选EVT进行治疗。

英文摘要：

Objective To compare and analyze the early efficacy and safety of intravascular treatment (EVT) andintravenous thrombolysis (IVT) in the treatment of posterior circulation acute ischemic stroke (AIS) . Methods A total of 147patients with posterior circulation AIS who received EVT or IVT at People's Hospital Affiliated to Xinxiang Medical Universityfrom January 2018 to May 2022 were selected as the study subjects. According to the treatment method, the patients were dividedinto EVT group (n=45) and IVT group (n=102) . The general data, early prognostic indicators (proportion of patients with goodfunctional prognosis 90 days after treatment, mortality within 90 days after treatment) and the safety indicators (the incidenceof symptomatic intracranial hemorrhage within 24 hours of treatment) were compared between the two groups. Results Theproportion of patients with good functional prognosis 90 days after treatment in IVT group (27.5%, 28/102) was lower than thatin EVT group (48.9%, 22/45) (P < 0.05) . There was no significant difference in mortality within 90 days after treatment betweenIVT group and EVT group (P > 0.05) . There was no significant difference in the incidence of symptomatic intracranial hemorrhagewithin 24 hours of treatment between IVT group and EVT group (P > 0.05) . Conclusion The early functional efficacy of EVT inthe treatment of posterior circulation AIS is better than that of IVT, but the early mortality rate and the incidence of symptomaticintracranial hemorrhage are similar between the two groups. In clinical practice, if patients with posterior circulation AIS meet theindications of EVT, EVT can be the first choice for treatment.

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