Efficacy analysis of endovascular therapy combined with hyperbaric oxygen intervention in acute anterior circulation macrovascular occlusive stroke
10.3760/cma.j.cn311847-20191115-00321
- VernacularTitle:急性前循环大血管闭塞性脑卒中血管内治疗联合高压氧干预的疗效分析
- Author:
Dongzhang XUE
1
;
Jincheng CHENG
1
;
Shiquan YANG
1
;
Yiqun WANG
1
;
Tian XIA
1
;
Hanchun WANG
1
;
Xiaolin LI
1
;
Jingjing LIU
1
;
Rui AI
1
;
Shaodan WU
1
;
Bensong YU
1
Author Information
1. 233015 安徽省蚌埠，解放军联勤保障部队第九〇二医院神经内科
- Publication Type:Journal Article
- Keywords:
Stroke;
Endovascular therapy;
Hyperbaric oxygen;
Homocysteine;
Hypersensitive C-reactive protein
- From:
Chinese journal of nautical medicine and hyperbaric medicine
2020;27(2):175-179
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore efficacy and safety of endovascular therapy combined with hyperbaric oxygen (HBO) intervention in acute anterior circulation macrovascular occlusion stroke.Methods:A total of 150 patients with acute anterior circulation macrovascular occlusive stroke admitted in No.902 Hospital of the CPLA Joint Logistic Support Force were selected and randomly divided into endovascular treatment group and combined treatment group (endovascular+ HBO). Endovascular therapy was adopted in the treatment of all patients. Modified thrombolytic flow grading (mTICI) was used to evaluate vascular recanalization after operation, and the incidences of complications of hemorrhage transformation and vascular re-occlusion were recorded. National institutes of health stroke scale (NIHSS) was used to evaluate the neurological functions on admission, at 24 hours after the operation, and one course after HBO therapy. The prognosis was evaluated by observing the changes of blood homocysteine (HCY) and high-sensitivity C-reactive protein (hs-CRP) levels before and after treatment. The patients had been followed up by the modified Rankin Scale (mRS) for 90 days. At the same time, 75 patients with acute anterior circulation macrovascular occlusive stroke without taking endovascular treatment were selected as the control group.Results:Among 150 patients, 126 cases had a grade of mTICI≥2b, while 24 cases had a grade of mTICI<2b. Postoperative vascular re-occlusion occurred in 3 cases, and symptomatic intracranial hematoma occurred in 6 cases. The NIHSS score at 24 hours after the operation was significantly lower than that on admission, and the NIHSS score was further improved after HBO treatment. Ninety days after the operation, mRS showed 98 cases of good prognoses, while 52 cases of poor prognoses. The levels of HCY and hs-CRP were significantly lower than those before the treatment.Conclusion:Endovascular therapy for acute anterior circulation macrovascular occlusive stroke is safe and effective. Postoperative HBO therapy can significantly improve the prognosis and the quality of life of patients.
