肢体缺血预适应联合超早期静脉溶栓减轻急性脑梗死患者神经功能缺损并改善预后  

Limb ischemic preconditioning combined with ultra-early intravenous thrombolysis can reduce neurological deficit and improve prognosis in patients with acute cerebral infarction

作　　者：苏俊 李鑫海 SU Jun;LI Xin-hai(Department of Neurology,Hanchuan People's Hospital of Hubei Province,Hanchuan 431600,China;Rehabilitation Medicine Department,Hanchuan People's Hospital of Hubei Province,Hanchuan 431600,China)

机构地区：[1]湖北省汉川市人民医院神经内科,湖北汉川431600 [2]湖北省汉川市人民医院康复医学科,湖北汉川431600

出　　处：《内科急危重症杂志》2021年第6期493-496,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨肢体缺血预适应联合超早期静脉溶栓治疗急性脑梗死(ACI)患者的疗效。方法:将湖北省汉川市人民医院2017年6月-2018年7月收治的98例ACI患者按照年龄及危险因素等分层匹配,分为对照组和联合组,各49例。2组患者均给予常规治疗,对照组给予重组组织型纤溶酶原激活剂(rt-PA)进行超早期静脉溶栓治疗,联合组给予肢体缺血预适应联合超早期静脉溶栓治疗。比较2组患者治疗前、后美国国立卫生研究院卒中量表(NIHSS)及改良Rankin量表(mRS)评分;对比临床疗效及不良反应;治疗后随访半年,采用格拉斯哥预后量表(GOS)评估患者的预后情况。结果:治疗后2组患者NIHSS及mRS评分降低,且联合组更低(P均<0.05);联合组总有效率显著高于对照组(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05),且均可耐受;联合组预后良好率明显高于对照组(95.92%vs 81.63%,P<0.05)。结论:肢体缺血预适应联合超早期静脉溶栓治疗ACI患者能够减轻患者神经功能的缺损,提升患者的综合生活能力。Objective:To explore the therapeutic effect of limb ischemic preconditioning combined with ultra-early intravenous thrombolysis for patients with acute cerebral infarction(ACI).Methods:Matching by age and risk factors,98 patients with ACI treated in Hanchuan People's Hospital of Hubei Province from June 2017 to July 2018 were divided into control group(n=49)and combined group(n=49).Both groups were given routine treatment,the control group was given recombinant tissue plasminogen activator(rt-PA)for ultra-early intravenous thrombolysis,and the combined group was given limb ischemic preconditioning combined with ultra-early intravenous thrombolysis.The scores of NIHSS and modified Rankin scale(mRS)were compared between the two groups before and after treatment.The clinical efficacy and adverse reactions were compared.Glasgow outcome scale(GOS)was used to evaluate the prognosis of patients after six months of follow-up.Results:After treatment,the NIHSS and mRS scores of the two groups decreased,and those in the combined group were lower than in the control group(P<0.05).The total effective rate in the combined group was significantly higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05),and the adverse reactions were tolerated.The good prognosis rate in the combined group was 95.92%,which was significantly higher than that in the control group(81.63%)(P<0.05).Conclusion:Limb ischemic preconditioning combined with ultra-early intravenous thrombolytic therapy can alleviate the neurological deficits of ACI patients,and improve the comprehensive living ability of patients.

关 键 词：肢体缺血预适应 静脉溶栓 急性脑梗死 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]