急性脑梗死两种溶栓治疗方法的安全性与疗效比较  

Combined intra-arterial /intravenous thrombolysis and intravenous thrombolysis in treatment of acute cerebral infarction

作　　者：李国斌[1,2] 李冬梅 高天[2] 徐祎[2] 杜世伟[2] 毛更生[2] 

机构地区：[1]新乡医学院,453003 [2]武警总医院神经血管外科,北京100039

出　　处：《武警医学》2013年第9期774-776,779,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的对比观察急性脑梗死(combined intra-arterial,ACI)超早期行动静脉联合溶栓与静脉溶栓的临床疗效及安全性。方法系统性回顾分析68例行动静脉联合溶栓或静脉溶栓治疗的ACI患者的临床资料,比较两组术后闭塞血管再通率、术后NIHSS评分、并发症等。结果联合组、静脉组患者术后7 d与术前相比,NIHSS评分差异均有统计学意义(P<0.05或P<0.01)。两组患者术后24 h、术后7 d NIHSS评分相比,差异有统计学意义(P<0.05);两组患者术后闭塞血管再通率相比,差异有统计学意义(P<0.05);两组患者术后出血发生率及病死率相比,差异无统计学意义(P>0.5)。结论对于ACI的治疗,动静脉联合溶栓的疗效优于静脉溶栓。Objective To evaluate the safety and efficacy of combined intra - arterial/intravenous thrombolysis versus intravenous thrombolysis for treatment of ACI in early stage. Methods The clinical data of pre - operation, postoperation and long - term fol- low - up of 68 patients with ACI were systematically reviewed. Results In combined thrombolysis group, there was significant difference in NIHSS score between postoperative and preoperative periods（P 〈 0.05）. In intravenous thrombolysis group, there was signifi- cant difference in NIHSS score between postoperative and preoperative periods （P 〈 0.01 ）. There was significant difference in postop- erative NIHSS score between the two groups（P 〈 0.05）. There was significant difference in the rate of recanalization between the two groups（P 〈 0.05 ）. The difference in the rate of complications and mortality between the two groups was not significant （ P 〉 0.05 ）. Conclusions The treatment of acute ischemic stroke with combined intra - arterial/ intravenous tbrombolysis is better than . intravenous thrombolysis alone.

关 键 词：急性脑梗死 溶栓治疗 神经介入 

分 类 号：R743.3[医药卫生—神经病学与精神病学]