多模式CT指导下静脉和动脉溶栓治疗急性脑梗死的效果和安全性比较  

To Compare the Effect and Safety of Multi Mode under the Guidance of CT Vein and Artery Thrombolysis for Acute Cerebral Infarction

作　　者：姜大景[1] 胡婷婷[1] 汪华[1] 向明清[1] 郭才华[1] 姜振威[1] 

机构地区：[1]长江大学医学院附属荆州市第一人民医院神经内科,湖北荆州434000

出　　处：《中国CT和MRI杂志》2016年第3期38-40,54,共4页Chinese Journal of CT and MRI

摘　　要：目的对多模式CT指导下静脉和动脉溶栓效果和安全性进行比较,寻求安全可靠的急性脑梗死治疗方法。方法选择我院2014年1月-2014年12月符合动脉溶栓条件的71例颈内动脉系统急性脑梗死患者,根据患者意愿分为两组,愿意接受动脉溶栓治疗的33例患者为动脉组,不愿接受动脉溶栓治疗的38例患者采用静脉溶栓,设为静脉组,记录溶栓前后各时间段患者神经功能缺损(NIHSS)评分和并发症,溶栓治疗1个月后评价疗效。结果动脉组患者溶栓后不同时间段NIHSS评分均低于静脉组(P<0.05)。动脉组患者基本痊愈11例,显著进步13例,总有效率为72.73%,对照组总有效率为44.74%(P<0.05)。溶栓1周后动脉组责任血管再通率为63.64%,静脉组责任血管再通率为42.11%,(χ2=6.3128,P<0.05)。两组并发症比较差异无统计学意义(χ2=1.2423,P>0.05)。结论多模式CT对判断急性脑梗死缺血半暗带和血管狭窄具有较好的指导作用,动脉溶栓药物浓度高,可提高血管再通率,因此更有助于疗效和生存质量的提高。Objective comparison of multi mode under the guidance of CT vein and artery thrombolytic efficacy and safety, seeking treatment for acute cerebral infarction is safe and reliable. Methods 71 cases of acute cerebral infarction of internal carotid artery system in patients of our hospital in 2014 January to choose December-2014 accord with intraarterial thrombolysis conditions, according to the wishes of patients were divided into two groups, willing to accept the 33 cases of arterial thrombolytic therapy in patients with arterial group, unwilling to accept the 38 patients were treated with thrombolytic therapy in patients treated with intravenous thrombolysis, set to vein group, recording the period of time before and after thrombolytic therapy for patients with neurological deficit（NIHSS） score and complications, curative effect evaluation of thrombolytic therapy after 1 months. Results Patients with arterial thrombolysis group at different time after NIHSS scores were lower than the intravenous group（P〈0.05）. Artery group of patients, 11 cases were basically cured, 13 cases were significantly improved, the total effective rate was 72.73%, control group, the total effective rate was 44.74%（P〈0.05）. After 1 weeks of group responsibility artery thrombolysis recanalization rate was 63.64%, and then through vein group responsible vessels rate was 42.11%,（χ2=6.3128, P〈0.05）. Two groups were no significant difference（χ2=1.2423, P〈0.05）. Conclusion multi mode CT to judge acute cerebral ischemic penumbra and vascular stenosis has good guide, arterial thrombolytic drug concentration is high, can improve the recanalization rate, it also helps to improve the efficacy and quality of life.

关 键 词：多模式 CT 静脉溶栓 动脉溶栓 急性脑梗死 

分 类 号：R445.3[医药卫生—影像医学与核医学] R743.33[医药卫生—诊断学]