rtPA动静脉联合溶栓治疗急性脑梗死疗效分析.doc

r-tPA动静脉联合溶栓治疗急性脑梗死疗效分析 2011年6月第49卷第18期 r-tPA动静脉联合溶栓治疗急性脑梗死疗效分析 赖春梅俞迪红鲁国建金国兴董芬马黎傅国萍 (绍兴第二医院神经内科,浙江绍兴312000) ? 临床探讨? 【摘要】目的评价重组组织型纤溶酶原激活物(r-tPA)动静脉联合溶栓治疗急性脑梗死的疗效及安全性.方法40例符合 入选标准的急性脑梗死患者按入院先后顺序分为治疗组和对照组,治疗组先予以卜tPA静脉溶栓,然后在DSA下动脉溶 栓,24h后常规予以抗血小板集聚,活血化瘀,营养脑细胞等治疗,对照组入院后即予以抗血小板集聚,扩张血管,脑神经保 护剂等治疗.两组均采用美国国立卒中研究中心卒中量表(NIHSS),Barthel指数(BI)评价治疗前,治疗24h,14d,21d,90d患 者的神经功能恢复状况.结果治疗组疗效明显优于对照组(Plt;0.05).治疗组并发症状性脑出血2例,死亡1例;对照组并 发症状性脑出血1例,无死亡病例.两组均无全身性出血发生.结论治疗组短期内能明显改善急性脑梗死患者的肢体功能 状况,大大提高了患者的生活质量,促进了临床预后的改善. 【关键词1卜tPA;动静脉联合溶栓;急性脑梗死 【中图分类号】R743.3【文献标识码】B【文章编号】1673—9701(2011)18—223—03 TheClinicalAnalysisofRecombinantTissuePlasminogenActivator (r—tPA)throughArteriovenousThrombolysistoCureAcuteCerebral Infarction LChunmeiYUDihongLUGuofiandinGuoxingDONGFenMAFUGuoping DepartmentofNeurology,theSecondHospitalofShaoxing,Shaoxing312000,China 【Abstract1ObjectiveToEvaluatethecurativeeffectandsafetyoftherecombinanttissueplasminogenactivator(r-tPA)combined withintravenousandintra-arterialthrombolysisintreatmentofpatientswithacutecerebralinfarction.MethodsFortyca$esaccording withclinicaldiagnosticcriteriaforacutecerebralinfarctionwererecruitedinthehospiml,whichdividedintothetreatmentgroupand controlgroup,thetreatmentgroupwastreatedwithintravenousthrombolysis,thenarterialthrombolysisinDSA,thereweregivenan— tiplateletconver~ng,promotingbloodcirculationtoremovebloodstasis,nutritionbraincellsetcafter24hours,whileonlythesamedrug incontrolgroup.Byevaluatingthenationalstrokeresearchcenterstrokescale(NIHSS)scoresandBarthelindex(BI)preandpost treatment(24hours,14days,21days,90days),neurologicalfunctionswereassessed.ResultsThecurativeeffectoftreatmentgroupis obfioushigherthanthatofcontrolgroup(Plt;O.05),thereweretwocerebralhemorrhageintreatmentgroup,andonedied.Thecontrol groupdidn’thavesyndrome,twogroupshavenosystemichemorrhage.ConclusionThetreatmentgroupcanobviouslydelelopthelimb functionalconditioninshorttime,greatlyimprovingthequalityoflife,andpromotingtheimprovementofclinicaloutcomes. 【Keywords】卜tPA;A