r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2023-28-5-52-59r-n-j-484Research ArticleИССЛЕДОВАНИЯ И КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯCLINICAL RESEARCHES AND CASE REPORTSОпыт реперфузионной терапии ишемического инсульта в региональном сосудистом центреExperience of reperfusion therapy of ischemic stroke in the Regional Stroke Centerhttps://orcid.org/0000-0001-9818-5549КазаковС. Д.KazakovS. D.

Томск.

Tomsk.

docstastomsk@gmail.comhttps://orcid.org/0000-0002-5528-1634ПлотниковД. М.PlotnikovD. M.

Томск.

Tomsk.

dmarkych@gmail.comhttps://orcid.org/0009-0002-0294-8551ПавлушкинаД. А.PavlushkinaD. A.

Томск.

Tomsk.

dashapavlushkina@gmail.comhttps://orcid.org/0000-0001-9612-8815КаневА. Ф.KanevA. F.

Томск.

Tomsk.

alexkanev92@gmail.comhttps://orcid.org/0000-0003-0814-8344КаменскихЕ. М.KamenskikhE. M.

Томск.

Tomsk.

kamenskih.em@ssmu.ruhttps://orcid.org/0000-0002-4140-3223АлифироваВ. М.AlifirovaV. M.

Томск.

Tomsk.

alifirova.vm@ssmu.ruСибирский государственный медицинский университет; Томская областная клиническая больницаРоссияSiberian State Medical University; Tomsk Regional Clinical HospitalRussian FederationСибирский государственный медицинский университетРоссияSiberian State Medical UniversityRussian Federation2023261120232855259Copyright © Казаков С.Д., Плотников Д.М., Павлушкина Д.А., Канев А.Ф., Каменских Е.М., Алифирова В.М., 20232023Казаков С.Д., Плотников Д.М., Павлушкина Д.А., Канев А.Ф., Каменских Е.М., Алифирова В.М.Kazakov S.D., Plotnikov D.M., Pavlushkina D.A., Kanev A.F., Kamenskikh E.M., Alifirova V.M.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/484Введение

Введение: восстановить кровоток в головном мозге при ишемическом инсульте (ИИ) позволяют современные методы реканализации — системная тромболитическая терапия (сТЛТ) и механическая тромбэкстракция (МТЭ).

Цель исследования

Цель исследования: анализ эффективности методов реперфузионной терапии ИИ, используемых в Региональном сосудистом центре (РСЦ) Томской областной клинической больницы (ТОКБ) с 2017 по 2022 г.

Материал и методы

Материал и методы. Проведена ретроспективная оценка 666 анализируемых случаев специфической терапии ИИ: в 505 применялась cТЛТ (67 [59,0; 75,0] лет), в 126 МТЭ (69 [60,5; 77,5] лет) и в 35 была использована комбинация сТЛТ с последующей МТЭ (69 [63,0; 76,7] лет).

Результаты

Результаты. Тяжесть неврологического дефицита по шкале инсульта Национального института здоровья США (National Institutes of Health Stroke Scale (NIHSS)) перед вмешательством была больше в группе МТЭ и сТЛТ + МТЭ (18 [14,0; 25,0] и 18 [14,5; 20,0] баллов) относительно пациентов, получивших сТЛТ (11 [8,0; 16,0] и 4 [2,0; 10,0]). Летальность в группе МТЭ составила (64/127, 50,8%) и была выше по сравнению с пациентами, получившими сТЛТ (104/505, 20,6%, p < 0,001). В группе пациентов, которым проводилось комбинированное вмешательство сТЛТ + МТЭ (9/27, 25,7%) отмечена тенденция к более низкой летальности (p = 0,050) по сравнению с изолированной МТЭ.

Заключение

Заключение. Выявлена тенденция к меньшему количеству летальных исходов при использовании комбинированного вмешательства в лечении ИИ по сравнению с изолированной МТЭ, что может свидетельствовать о более высокой эффективности этапной реперфузии. 

Introduction

Introduction. Modern methods of recanalization — systemic thrombolytic therapy (STT) and mechanical thrombectomy (MT) — allow restoring blood fl ow in the brain tissue in ischemic stroke (IS).

Purpose of the study

Purpose of the study: to analyze the effectiveness of IS reperfusion therapy methods used in the Regional Stroke Center (RSC) of the Tomsk Regional Clinical Hospital from 2017 to 2022.

Material and methods

Material and methods. A retrospective evaluation of 666 analyzed cases of specific therapy for IS was performed: 505 cases of STT (67 [59.0; 75.0] years), 126 cases of MT (69 [60.5; 77.5] years), 35 cases a combination of STT followed by MT (69 [63.0; 76.7] years).

Results

Results. The severity of neurological deficit according to the National Institutes of Health Stroke Scale (NIHSS) before the intervention was greater in the MT and STT + MT groups (18 [14.0; 25.0] and 18 [14.5; 20.0] points) relative to patients who received STT (11 [8.0; 16.0] and 4 [2.0; 10.0]). Mortality in the MTE group was (64/127, 50.8%) and was higher compared to patients who received STT (104/505, 20.6%, p < 0.001). In the group of patients who underwent combined intervention with STT + MT (9/27, 25.7%), there was a trend towards lower mortality (p = 0.050) compared with isolated MT.

Conclusion

Conclusion. A trend towards fewer deaths was found when using a combined intervention in the treatment of IS compared with isolated MT, which may indicate a higher effi ciency of bridging-therapy.

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The authors declare that there are no conflicts of interest present.