经颅多普勒超声辅助阿替普酶静脉溶栓治疗急性缺血性脑卒中的疗效分析  

Observation of curative effect of intravenous thrombolysis with alteplase assisted by continued monitoring with transcranial Doppler ultrasound for acute ischemic stroke

作　　者：兰俊 肖芸丽 王艳莉 张海静 李国臣 

机构地区：[1]十堰市中西医结合医院神经内科,湖北十堰442011

出　　处：《中国实用神经疾病杂志》2018年第3期266-269,共4页Chinese Journal of Practical Nervous Diseases

基　　金：2014年十堰市科学技术研究与开发项目(No:14Y71)

摘　　要：目的观察经颅多普勒超声(TCD)持续监测辅助阿替普酶静溶栓治疗急性缺血性脑卒中的临床疗效。方法将发病时间在静脉溶栓时间窗内的60例大脑中动脉狭窄或闭塞所致的急性缺血性脑卒中患者随机分为治疗组和对照组。2组均予以阿替普酶静脉溶栓治疗,治疗组在静脉溶栓过程中给予TCD持续监测。分别在治疗前及治疗后24h进行NIHSS评分;以TCD-TIBI分级评估溶栓后24h血管再通情况。溶栓后90d时进行mRS评分,并进行比较。结果治疗组溶栓24h后与对照组NIHSS评分比较差异有统计学意义(t=-2.037,P=0.046);溶栓后24h治疗组血管再通比率高于对照组,差异有统计学意义(χ2=10.613,P=0.005);溶栓后24h2组均未见症状性颅内出血(Z=0.00,P=1.00),溶栓后90d治疗组mRS平均分低于对照组,差异有统计学意义(t=-2.494,P=0.016)。结论 TCD持续监测辅助阿替普酶静脉溶栓治疗急性脑梗死的疗效较好,且无明显不良反应。Objective To observe the curative effect of intravenous thrombolysis with alteplase assisted by continued moni- toring with transcranial Doppler ultrasound to treat acute ischemic stroke. Methods Sixty patients with acute ischemic stroke caused by middle cerebral artery stenosis or occlusion were randomly divided into TCD auxiliary thrombolysis group and the con- trol group. Both groups were given thrombolysis,and TCD group given TCD continuous monitoring in the process of intravenous thrombolysis. The NIHSS score before and 24-hour after thrombolysis, TCD-TIBI grading 24-hour after thrombolysis and mRS scores 90 days after thrombolysis in both groups were compared. Results There were statistical differences of NIHSS between TCD auxiliary thrombolysis group and control group 24 hours after thrombolysis （t=-2. 037,P=0. 046）. The rate of recanaliza tion in TCD auxiliary thrombolysis group was higher than the control group 24 hours after thrombolysis, and these two have differences statistically （χ^2= 10. 613,P =0. 005）;the rate of symptomatic intracranial hemorrhage was 0% in both groups 24 hours after thrombolysis with no differences statistically（Z=0.00, P = 1.00） ;90 days after thrombolysis, the mRS score of TCD auxiliary thrombolysis group was lower than the control group with differences statistically（t =- 2. 494, P = 0. 016）. Conclusion The curative effect of intravenous thrombolysis with alteplase assisted by continued monitoring with transcranial Doppler ultra- sound to treat acute ischemic stroke is good with no obvious adverse reactions.

关 键 词：经颅多普勒 阿替普酶 静脉溶栓 急性缺血性脑卒中 血管再通 

分 类 号：R743.33[医药卫生—神经病学与精神病学]