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目的比较Solitaire支架机械取栓与选择性动脉溶栓治疗急性脑梗死的临床疗效。方法回顾性分析2014年1月至2016年5月遵义市第一人民医院神经科因大动脉狭窄或闭塞导致急性中重度脑梗死接受动脉溶栓或机械取栓的82例患者的临床资料，比较分析介入治疗后血管再通mTICI评级、治疗前后NIHSS评分、出血情况及90 d神经功能恢复情况。结果机械取栓42例（机械取栓组），动脉溶栓40例（动脉溶栓组），机械取栓组患者治疗后总有效率达到85.70%，动脉溶栓组总有效率62.50%，2组比较，差异有统计学意义(P<0.05)；与治疗前相比，2组治疗后NIHSS评分呈下降趋势，治疗后1周机械取栓组疗效优于动脉溶栓治疗组，差异具有统计学意义(P<0.05）；机械取栓相比动脉溶栓出血率较低，差异具有统计学意义（P<0.05）。结论支架机械取栓方法与动脉溶栓比较，时间窗可以适当放宽，溶栓效果、安全性及远期临床预后较好。
Objective To compare the clinical effects of solitaire mechanical thrombectomy and selective arterial thrombolysis in the treatment of acute cerebral infarction. Methods The clinical data of 82 patients who underwent arterial thrombolysis or mechanical thrombectomy due to stenosis or occlusion of the aorta in the First People’s Hospital of Zunyi from January 2014 to May 2016 were retrospectively analyzed. The mTICI level of recanalization after interventional therapy, NIHSS score before and after treatment, bleeding status and neurological function recovery after 90 days. Results The total effective rate of mechanical embolectomy in 42 cases (mechanical thrombolysis group) and arterial thrombolysis in 40 cases (arterial thrombolysis group) was 85.70% in the mechanical thrombectomy group and 62.50% in the arterial thrombolysis group The difference was statistically significant (P <0.05). Compared with before treatment, the NIHSS score of the two groups showed a decreasing trend. The effect of mechanical thrombectomy group was better than arterial thrombolysis group one week after treatment, the difference was statistically significant (P & lt; 0.05). The rate of hemorrhage after thrombolysis was lower than that of arterial thrombolysis (P & lt; 0.05). Conclusion Compared with arterial thrombolysis, the time window can be appropriately relaxed. The thrombolytic effect, safety and long-term clinical prognosis are good.