ABSTRACT
Objective:To assess the efficacy of butylphthalide and sodium chloride injection combined with interventional therapy in treatment of patients with acute anterior circulation macrovascular occlusive stroke.Methods:Clinical data of 92 patients with acute anterior circulation macrovascular occlusive stroke admitted to the Department of Neurology of Luoyang Central Hospital Affiliated to Zhengzhou University from February 2018 to June 2019 were retrospectively analyzed. Among them, 46 cases were treated with auxiliary arterial thrombolysis, aspiration thrombectomy or balloon dilatation (control group); and 46 patients were treated with butylphthalide and sodium chloride injection combined with Solitaire AB (S-AB) recyclable stent (study group). In control group the lesions were located in distal end internal carotid artery ( n=4), M1 segment of middle cerebral artery ( n=18) and M2 segment of middle cerebral artery ( n=24). In study group the lesions were located in the distal end of internal carotid artery ( n=5), M1 segment of middle cerebral artery ( n=15) and M2 segment of middle cerebral artery ( n=26). The cerebral infarction thrombolysis classification was used to evaluate vascular recanalization during operation. The neurological function of the patients before and 4 weeks after operation was evaluated with National Institutes of Health Stroke Scale Score (NIHSS); and the Disease Disability Scale Score (MRS) was also used to evaluate the neurological function before and 2 and 4 weeks after operation. Results:There was no significant difference in NIHSS score before treatment between control group and study group (22.8±5.2 vs. 23.4±4.1, t=0.614, P=0.54); after treatment the NIHSS of study group was significantly lower than that of control group (7.6±1.1 vs. 12.2±1.6, t=16.068, P<0.01). The success rate of vascular recanalization in the study group was higher than that of the control group [91%(42/46) vs. 76%(35/46), χ 2=3.903, P=0.04]. The short-term recanalization rate was 84% (39/46) and occlusion rate was 15%(7/46) in study group, while those in control group were 70% (32/46) and 30% (14/46), respectively (χ 2=6.566, P=0.01; χ 2=6.566, P=0.01) . MRS scores at 2 and 4 weeks after operation in the study group (5.51±0.34, 2.39±0.47) were better than those in the control group (6.87±0.46, 3.26±0.39; t=16.125, 9.661, all P<0.01) . Conclusion:Butylphthalide and sodium chloride injection combined with S-AB recyclable stent can enhance the nerve function and improve the hemagglutination mechanism in patients with acute anterior circulation macrovascular occlusive stroke and also significantly improve the vascular recanalization rate.