急诊静脉内溶栓对急性脑卒中患者的临床效果  

Clinical Effect of Emergency Intravenous Thrombolysis on Acute Stroke Patients

作　　者：徐锋[1] 陈敏 XU Feng;CHEN Min(Department of Neurology,The First Hospital of Danjiangkou,Danjiangkou Hubei 442000,China;The First Hospital of Danjiangkou,Danjiangkou Hubei 442000,China)

机构地区：[1]湖北省丹江口市第一医院神经内科,湖北丹江口442000 [2]湖北省丹江口市第一医院泌尿外科,湖北丹江口442000

出　　处：《中国继续医学教育》2020年第25期131-134,共4页China Continuing Medical Education

摘　　要：目的研究急性缺血性脑卒中患者急诊时接受静脉内溶栓对到院至给药时间(DNT)的影响及其安全性。方法选取医院2017年10月—2019年4月间收治的90例急性缺血性脑卒中患者为研究对象,将其随机分为对照组(n=45)和观察组(n=45)。采取常规病房启动溶栓模式干预对照组患者,急诊时接受静脉内溶栓模式干预观察组患者。比较两组患者的治疗后的各项治疗时间及并发症发生率,同时比较出院后的肢体功能、生活质量评分。结果观察组的DNT、发病至就诊时间均明显低于对照组(P<0.05),而两组的住院时间比较差异无统计学意义(P>0.05);观察组患者出现死亡、脑出血、昏迷不醒等不良反应的发生率与对照组比较,差距均不具有统计学意义(P>0.05);6个月后,观察组患者的Fugl-Meyer运动功能积分和Bl均明显高于对照组(P<0.05)。结论急诊时接受静脉内溶栓可明显缩短对急性缺血性脑卒中患者的DNT,显著减少患者并发症的发生,改善肢体功能,提高生活质量。Objective To investigate the effect and safety of intravenous thrombolysis in patients with acute ischemic stroke on the time of admission to the time of administration(DNT).Methods From October 2017 to April 2019,90 patients with acute ischemic stroke were randomly divided into control group(n=45)and observation group(n=45).The patients of the control group were treated with the thrombolytic therapy in the conventional ward,and the patients with the observation group were treated with the intravenous thrombolysis in the emergency.The treatment time and complication rate after treatment were compared between the two groups,and the limb function and quality of life score after discharge were compared.Results The DNT and onset time of the observation group were significantly lower than the control group(P<0.05),but there was no significant difference in the hospitalization time between the two groups(P>0.05).The observation group showed death,cerebral hemorrhage and coma.The incidence of adverse reactions such as waking was not statistically significant compared with the control group(P>0.05).After 6 months,the Fugl-Meyer motor function scores and Bl were significantly higher in the observation group than in the control group(P<0.05).Conclusion Intravenous thrombolysis in the emergency department can significantly shorten the DNT in patients with acute ischemic stroke,significantly reduce the occurrence of complications,improve limb function,improve quality of life.

关 键 词：急性缺血性脑卒中 急诊静脉内溶栓 常规病房启动溶栓模式 Fugl-Meyer运动功能积分 BARTHEL指数 并发症 

分 类 号：R743[医药卫生—神经病学与精神病学]