超早期动脉溶栓治疗老年急性脑梗死的疗效分析  

Effectiveness of ultra-early cerebral arterial thrombolysis in elderly patients with acute cerebral infarction

作　　者：吴莘[1] 唐人彦 尹小燕[1] 洪声[1] WU Shen;TANG Renyan;YIN Xiaoyan;HONG Sheng(Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院,上海200011

出　　处：《中国实用神经疾病杂志》2021年第15期1319-1325,共7页Chinese Journal of Practical Nervous Diseases

基　　金：海南省医药卫生科研项目(编号:20A200044)。

摘　　要：目的探讨老年急性脑梗死患者超早期动脉内溶栓治疗的疗效。方法回顾性分析2017-01—2018-12上海交通大学医学院附属第九人民医院80例确诊老年急性脑梗死患者的临床资料,甲组40例行超早期静脉内溶栓,乙组40例行超早期动脉内溶栓。比较2组血管再通率、疗效、神经功能与预后情况。结果乙组血管再通率(90.00%)高于甲组(67.50%),优良率(92.50%)高于甲组(62.50%),1年期并发症发生率(2.50%)低于甲组(22.50%),差异有统计学意义(P<0.05)。2组治疗前NIHSS评分比较差异无统计学意义(P>0.05),治疗即刻、治疗后2 h、24 h与72 h乙组NIHSS评分较甲组更低,差异有统计学意义(P<0.05)。结论在老年急性脑梗死患者的临床治疗中采取超早期动脉内溶栓,可进一步优化患者血管再通情况,改善神经功能,预后较佳,整体疗效显著。Objective To investigate the efficacy of ultra-early intra-arterial thrombolysis in elderly pa-tients with acute cerebral infarction.MethodsThe clinical data of 80 patients with diagnosed elderly patientswith acute cerebral infarction in Shanghai Ninth People’s Hospital,Shanghai JiaoTong University School of Medi-cine were retrospectively analyzed from January 2017 to December 2018. Forty patients in group A underwent ul-tra-early intravenous thrombolysis,and 40 patients in group B underwent ultra-early intra-arterial thrombolysis. Thevascular recanalization rate,curative effect,neurological function and prognosis of the two groups were compared.ResultsThe vascular recanalization rates in group B(90.00%)were higher than those of group A(67.50%);thegood treatment rate in group B(92.50%)was higher than that of group A(62.50%);the one-year complicationrate in group B(2.50%)was lower than that of group A(22.50%)(P<0.05). Before treatment,NIHSS(NationalInstitute of Health stroke scale)scores between groups showed no statistically significant difference(P>0.05);up-on therapy,after 2 h,24 h and 72 h of therapy,NIHSS scores in group B were lower than those of group A(P<0.05).ConclusionThe ultra-early cerebral arterial thrombolysis can improve the overall effects,vascular recanali-zation rate,neurological function and treatment prognosis for elderly acute cerebral infarction patients.

关 键 词：急性脑梗死 超早期 动脉内溶栓 静脉内溶栓 神经功能 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]