关键词: 缺血性脑卒中, 静脉溶栓, 机械取栓术, 预后, 影响因素

Abstract: Objective  To explore the effect and prognostic factors of intravenous thrombolysis combined with Trevo stent mechanical thrombectomy in the treatment of ischemic stroke.Methods  A total of 120 patients with ischemic stroke diagnosed and treated in our hospital from January 2020 to December 2022 were selected as research objects and divided into two groups according to random number table method,with 60 cases in each group.Both groups were given basic treatment,the control group was given intravenous thrombolytic therapy,and the observation group was given intravenous thrombolytic therapy combined with mechanical thrombectomy with Trevo stent.The clinical efficacy of the two groups was observed, and the patients were divided into a good prognosis group (46 cases) and a poor prognosis group (74 cases) according to the prognosis. Clinical data such as gender, age, BMI, combined hypertension, combined diabetes, smoking, treatment methods, complete vascular recirculation rate, preoperative NIHSS score and postoperative NIHSS score of the two groups were collected. The independent prognostic factors were analyzed by univariate and multivariate binary Logistic regression.Results  The total effective rate of the study group was significantly higher 88.33%(53/60)than that of the control group 73.33%(44/60),and the difference was statistically significant (P<0.05).Univariate analysis showed that there were no statistically significant differences in gender, BMI, diabetes mellitus, and preoperative NIHSS score between the two groups (P>0.05), while there were statistically significant differences in age, hypertension, smoking, treatment style, complete vascular revasculosity, and postoperative NIHSS score between the two groups (P<0.05). Logistic regression analysis showed that age, treatment style and complete vascular revasculopathy rate were independent factors affecting the prognosis of ischemic stroke patients (P< 0.05).Conclusion  Intravenous thrombolysis combined with mechanical thrombectomy with Trevo stent can improve the clinical efficacy and prognostic quality of ischemic stroke patients in the time window of intravenous thrombolysis.In addition,the prognosis of patients with ischemic stroke is also closely related to the age of patients and the rate of complete vascular recirculation after surgery.

Key words: Ischemic stroke, intravenous thrombolysis, mechanical thrombectomy, prognosis, Influencing factor