脑梗死患者r-tPA溶栓中TCD的变化及其临床意义  

Changes of TCD and Its Clinical Significance in r-t PA Thrombolytic of Patients with Cerebral Infarction

作　　者：陈敏[1] 龙双祁 彭超[1] 谢明[1] 

机构地区：[1]南华大学附属第一医院,湖南衡阳421001 [2]湖南省永州市中心医院

出　　处：《中国医学创新》2016年第2期50-53,共4页Medical Innovation of China

摘　　要：目的:探究脑梗死患者注入重组组织型纤溶酶原激活剂(r-t PA)进行溶栓治疗中经颅多普勒超声(TCD)的变化及其临床意义。方法:选择本院2014年5-11月收治的脑梗死且符合溶栓标准的患者76例,根据是否应用TCD监测将其分为观察组和对照组,每组各38例。观察组给予r-t PA溶栓联合TCD检测,对照组单纯给予r-t PA溶栓治疗。检测两组患者血管再通和颅内出血情况,测定两组不同时间段NIHSS评分和Barthel指数,观察治疗后并发症发生情况。结果:观察组血管再通率76.32%明显高于对照组的44.74%,差异有统计学意义(P<0.05),而两组颅内出血率比较差异无统计学意义(P>0.05),而观察组治疗后7 d和3周的NIHSS评分均明显低于对照组,且治疗后1个月和3个月的Barthel指数均明显高于对照组,总并发症发生率5.26%明显低于对照组的21.05%,差异均有统计学意义(P<0.05)。结论:TCD在脑梗死患者r-t PA溶栓治疗中具有良好的协同作用,不仅能增加血管再通率,减小颅内出血的发生,而且在改善患者的神经功能恢复方面效果明显,值得临床推广。Objective：To explore the changes of transcranial Doppler（TCD） and its clinical significance in recombinant tissue plasminogen activator（r-tPA） thrombolytic therapy of patients with cerebral infarction.Method：76 cerebral infarction patients who met the standard of thrombolytic in our hospital from May 2014 to November 2014 were selected,and were randomly divided into the observation group and the control group according to whether the application of TCD monitoring,38 cases in each group.The observation group was treated with r-tPA combined with TCD,and the control group was treated with r-tPA.The revascularization and intracranial hemorrhage between the two groups were detected,and the NIHSS score and Barthel index between the two groups in different time periods were determined,the complications after treatment between the two groups were observed.Result：The revascularization rate of the observation group was 76.32%,which was significantly higher than 44.74% of the control group,the difference was statistically significant（P〈0.05）,there was no statistically significant difference in intracranial hemorrhage rate between the two groups（P〉0.05）.The NIHSS score of the observation group 7 days and 3 weeks after treatment were significantly lower than those of the control group, the Barthel index of the observation group 1 month and 3 months after treatment were significantly higher than those of the control group,the total complication rate of the observation group was 5.26%,which was significantly lower than 21.05% of the control group,the differences were statistically significant（P〈0.05）. Conclusion：TCD in cerebral infarction patients r-tPA thrombolytic therapy has good synergistic effect,not only can increase the recanalization rate,reduce the intracranial hemorrhage,but also has significant effect in the improvement of patients with neurological function recovery,is worthy of clinical promotion.

关 键 词：脑梗死 溶栓 重组组织型纤溶酶原激活剂 经颅多普勒 

分 类 号：R743.3[医药卫生—神经病学与精神病学]