常规时间窗与扩大时间窗动、静脉联合溶栓治疗急性脑梗死临床疗效的对比研究  

Comparative Study for Clinical Effect on Acute Cerebral Infarction between Routine and Extended Time-window Arteriovenous Thrombolysis

作　　者：江天丽 马烈 傅新民[2] 张磊 张正祥[3] 张莉文[3] 王磊 张洋[2] 

机构地区：[1]东莞康华医院神经内科,广东省东莞市523080 [2]东南大学医学院附属徐州医院(徐州市中心医院)神经内科,江苏省徐州市221009 [3]南京医科大学附属南京明基医院神经内科,江苏省南京市210019

出　　处：《实用心脑肺血管病杂志》2017年第3期65-68,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：广东省东莞市科技计划项目(2014105101028)

摘　　要：目的比较常规时间窗与扩大时间窗动、静脉联合溶栓治疗急性脑梗死的临床疗效。方法选取2014年5月—2016年2月东莞康华医院神经内科收治的急性脑梗死患者70例,按照发病时间分为A组(发病时间<4.5 h)与B组(发病时间4.5~8.0 h),每组35例。A组患者行常规时间窗动、静脉溶栓治疗,B组患者行扩大时间窗动、静脉溶栓治疗。比较两组患者临床疗效,治疗前及治疗后24 h、7 d、14 d美国国立卫生研究院卒中量表(NIHSS)评分,治疗后28 d Barthel指数(BI)评分;并观察两组患者并发症发生情况。结果两组患者临床疗效比较,差异无统计学意义(P>0.05)。治疗前及治疗后24 h、7 d、14 d两组患者NIHSS评分比较,差异无统计学意意义(P>0.05)。治疗后28 d两组患者BI评分比较,差异无统计学意义(P>0.05)。两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论常规时间窗与扩大时间窗动、静脉联合溶栓治疗急性脑梗死的临床疗效相当,均可有效改善患者神经功能,提高患者日常生活活动能力,且扩大时间窗动、静脉联合溶栓治疗未增加出血风险,安全性较高。Objective To comparethe clinical effect on acute cerebral infarction between routine and extended time - window arteriovenous thrombolysis. Methods From May 2014 to February 2016, a total of 70 patients with acute cerebral infarction were se]ected in the Department of Neurology, Kangbua Hospital of Dongguan, and they were divided into A group （ with duration between attack and thrombolysis less than 4. 5 hours） and B group （with duration between attack and thrombolysis equal or over 4.5 hours but equal or less than 8.0 hours） according to duration between attack and thrombolysis, each of 35 cases. Patients of A group received routine time - window arteriovenous thrombolysis, while patients of B group received extended time -window arteriovenous thrombolysis. Clinical effect, NIHSS score before treatment, after 24 hnu~, 7 days and 14 days of treatment, Barthel index after 28 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 （ P 〉 0.05 ）. No statistically significant differences of NIHSS score was found between the two groups before treatment, alter 24 hours, 7 days or 14 days of treatment （P 〉 0. 05）. No statistically significant differences of Barthel index was found between the two groups after 28 days of treatment （ P 〉0.05 ）. No statistically significant differences of incidence of complications was found between the two groups （P 〉 0. 05）. Conclusion Extended time - window arteriovenous thrombolysis has similar clinical effect with routine time - window arteriovenous thrombolysis in treating acute cerebral infarction, both routine and extended time - window arteriovenous thrombolysis can effectively improve the neurological function and activity of daily living, without increasing the risk of hemorrhage, is relatively safe.

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]