超选择性动脉溶栓与静脉溶栓治疗急性脑梗死的临床效果对比  

Comparative Study for Clinical Effect on Acute Cerebral Infarction between Ultra-selective Intraarterial Thrombolysis and Intravenous Thrombolysis

作　　者：邹蓉[1] 刘朝霞[1] 曲晓宁[1] 张振[1] 

机构地区：[1]滨州医学院烟台附属医院神经内科,山东省烟台市264100

出　　处：《实用心脑肺血管病杂志》2015年第8期47-50,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的比较超选择性动脉溶栓与静脉溶栓治疗急性脑梗死的临床效果。方法选取滨州医学院烟台附属医院2013年8月—2014年3月收治的急性脑梗死患者120例,按照随机数字表法分为动脉溶栓组和静脉溶栓组,每组60例。动脉溶栓组患者给予超选择性动脉溶栓治疗,静脉溶栓组患者给予静脉溶栓治疗。比较两组患者临床效果,溶栓前及溶栓后2 h、12 h、24 h、3 d、7 d、15 d、30 d美国国立卫生研究院卒中量表(NIHSS)评分,溶栓前及溶栓后6 h、3 d、7 d凝血指标〔凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(FIB)〕,观察并发症发生情况。结果两组患者临床效果比较,差异无统计学意义(u=0.064,P>0.05)。两组患者溶栓前及溶栓后15 d、30 d NIHSS评分比较,差异无统计学意义(P>0.05);动脉溶栓组患者溶栓后2 h、12 h、24 h、3 d、7 d NIHSS评分均低于静脉溶栓组(P<0.05)。溶栓前两组患者TT、PT及FIB水平比较,差异无统计学意义(P>0.05);动脉溶栓组患者溶栓后6 h、3 d、7 d TT、PT长于静脉溶栓组,溶栓后6 h、3 d FIB水平高于对照组(P<0.05);溶栓后7 d两组患者FIB水平比较,差异无统计学意义(P>0.05)。动脉溶栓组并发症发生率为6.17%,低于静脉溶栓组的25.00%(P<0.05)。结论超选择性动脉溶栓与静脉溶栓治疗急性脑梗死的临床效果相当,但超选择性动脉溶栓治疗起效时间短,且并发症少。Objective To compare the clinical effect on acute cerebral infarction between ultra -selective intraarterial thrombelysis and intravenous thrombolysis. Methods From August 2013 to March 2014 in Yantai Affiliated Hospital of Binzhou Medical College, a total of 120 patients with acute cerebral infarction were selected, and they were divided into A group and B group according to random number table, each of 60 cases. Patients of A group were treated by ultra - selective intraarterial thrombolysis, while patients of B group were treated by intravenous thrombolysis. Clinical effect, NIHSS score before treatment and after 2 hours, 12 hours, 24 hours, 3 days, 7 days, 15 days, 30 days of treatment, coagulation indicators （including TY, PT and FIB） before treatment and after 6 hours, 3 days, 7 days of treatment were compared between the two groups, and incidence of complications was observed. Results No statistically significant differences of clinical effect was found between the two groups （ u = 0. 064, P 〉 0. 05 ）. No statistically significant differences of NIHSS score was found between the two groups before treatment or after 15 days, 30 days of treatment （ P 〈0. 05 ） ; after 2 hours, 12 hours, 24 hours, 3 days, 7 days of treatment, NIHSS score of A group was statistically significantly lower than that of B group, respectively. No statistically significant differences of TY, PT or FIB was found between the two groups before treatment （ P 〉 0. 05 ） ; TI＇ and PT of A group were statistically significantly longer than those of B group after 6 hours, 3 days, 7 days of treatment, and FIB of A group was statistically significantly higher than that of B group after 6 hours, 3 days of treatment, respectively （ P 〈 0. 05 ）, but no statistically significant differences of FIB was found between the two groups after 7 days of treatment （P 〉 0. 05 ）. The incidenceof complications of A group was 6. 17%, was statistically significantly lower than that of B group of 25. 00% （ P 〈 0. 05 ）. Co

关 键 词：脑梗死 血栓溶解疗法 疗效比较研究 

分 类 号：R743.33[医药卫生—神经病学与精神病学]