Effect of Standardized Perioperative Management on EEG Indexes and Nerve and Limb Functions of Patients with Acute Cerebral Infarction Undergoing Mechanical Thrombectomy

Abstract

Objective. To explore the application value of standardized perioperative management in mechanical thrombectomy for acute cerebral infarction. Methods. 98 patients with acute cerebral infarction admitted to our hospital from January 2019 to January 2022 were selected as the study sample in this study, and all patients were given the standardized perioperative management. According to the interventional methods, they were divided into the thrombolytic treatment group (arteriovenous combined thrombolysis, n = 49 ) and mechanical thrombectomy group (mechanical thrombectomy, n = 49 ) to compare the nerve function, limb function, thrombolysis in myocardial infarction (TIMI) flow grade, symptomatic intracranial hemorrhage within 24 hours, acute vascular reocclusion, and the death status within 1 year and incidence of adverse events in 90 days of the two groups after treatment. Results. After treatment, the values of brain symmetry index (BSI) and power ratio indices (DTABR) in the two groups were obviously lower than those before treatment ( P < 0.05 ), and the values of BSI and DTABR in the mechanical thrombectomy group were lower than those in the thrombolytic treatment group ( P < 0.05 ). According to the statistical data of National Institutes of Health Stroke Scale (NIHSS) score in patients, the NIHSS scores of the two groups after treatment were visibly decreased ( P < 0.05 ), while the NIHSS score in the mechanical thrombectomy group after treatment was lower than that in the thrombolytic treatment group ( P < 0.05 ). The proportion of modified Rankin scale (mRS) score < 3 in the mechanical thrombectomy group was distinctly higher than that in the thrombolytic treatment group ( P < 0.05 ). The proportion of TIMI flow grade ≥ 2 in the mechanical thrombectomy group was significantly higher than that in the thrombolytic treatment group ( P < 0.05 ). The rate of symptomatic intracranial hemorrhage within 24 hours in the mechanical thrombectomy group was lower than that in the thrombolytic treatment group ( P < 0.05 ), with the indistinctive difference between the two groups ( P > 0.05 ). The incidence of acute vascular reocclusion in the mechanical thrombectomy group was markedly lower than that in the thrombolytic treatment group ( P < 0.05 ). There was no significant difference in 1-year mortality between the two groups ( P > 0.05 ). In the mechanical thrombectomy group, there were 1 case of gingiva bleeding, 1 case of hemorrhinia, and 2 cases of recurrent cerebral infarction in 90 days, with a total of 4 cases (8.16%), while in the thrombolytic treatment group, there were 4 cases of gingiva bleeding, 4 cases of hemorrhinia, and 15 cases of recurrent cerebral infarction in 90 days, with a total of 23 cases (46.94%), indicating that the incidence of adverse events in 90 days in the mechanical thrombectomy group was significantly lower than that in the thrombolytic treatment group ( P < 0.05 ). Conclusion. The standardized perioperative management is effective in patients with acute cerebral infarction who were treated with arteriovenous combined thrombolysis or mechanical thrombectomy, which can improve the neurological function and physical function of patients. However, the mechanical thrombectomy has a better improvement effect on the neurological function and physical function of patients, with the relatively better safety, thrombolytic effect, and long-term prognosis.

The effect of butylphthalide on improving the neurological function of patients with acute anterior circulation cerebral infarction after mechanical thrombectomy

“…288 patients with acute anterior circulation cerebral infarction who were admitted to the Department of Neurology in our hospital from January 2019 to November 2022 and were treated with mechanical thrombectomy for the first time were included in this retrospective study and divided into the butylphthalide group (n = 144) and control group (n = 144) that they received treatment methods. Inclusion criteria: The diagnosis of imaging combined with clinical symptoms conforms to the diagnostic criteria of “acute anterior circulation cerebral infarction” in the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2018; [ 7 ] The time from onset to operation is <72 hours. Exclusion criteria: Patients with severe dysfunction of important organs such as heart, liver, and kidney.…”

“…[4,5] When the current circulation is blocked, the main arteries of the cerebral artery and the internal carotid artery will be blocked, causing brain edema and other conditions, resulting in nerve damage to the function of the corresponding region, language, movement, sensation and other obstacles, which will seriously threaten the life of patients. [6,7] At present, intravenous thrombolysis is the main method to treat cerebral infarction in clinic, but this method XW and XL contributed equally to this work.…”

“…[ 4 , 5 ] When the current circulation is blocked, the main arteries of the cerebral artery and the internal carotid artery will be blocked, causing brain edema and other conditions, resulting in nerve damage to the function of the corresponding region, language, movement, sensation and other obstacles, which will seriously threaten the life of patients. [ 6 , 7 ] At present, intravenous thrombolysis is the main method to treat cerebral infarction in clinic, but this method requires a strict time window and cannot fundamentally solve vascular stenosis or thrombosis in situ. [ 8 ] The mechanical thrombectomy method removes the thrombus in the blood vessel in a mechanical way to reopen the occluded blood vessel, which has been widely used in clinical practice in recent years.…”