急性脑梗死尿激酶静脉溶栓与DSA引导下超选择性动脉溶栓的疗效对比分析  

Comparative analysis on efficacy of intravenous urokinase thrombolysis and DSA-guided super-selective arterial thrombolysis in acute cerebral infarction

作　　者：李乐 LI Le(Department of Neurology,Pubei County People’s Hospital,Pubei County,Guangxi Zhuang Autonomous Region,530000,China)

机构地区：[1]浦北县人民医院神经内科,广西浦北535300

出　　处：《蛇志》2022年第1期34-37,共4页Journal of Snake

摘　　要：目的探讨尿激酶静脉溶栓与数字减影血管造影(DSA)引导下超选择性动脉溶栓的疗效及安全性。方法选取2015年7月~2020年5月我院收治的120例急性脑梗死患者为研究对象,随机分为研究组和对照组各60例。研究组行DSA检查后直接行尿激酶超选择性动脉溶栓,对照组行传统尿激酶静脉溶栓治疗。观察两组患者的疗效,比较两组患者溶栓前及溶栓后6、24 h和14 d后的神经功能缺损(NIHSS)评分,以及治疗前、治疗14 d的Barthel(BI)指数,并比较两组患者的出血发生率。结果研究组的治疗效果显著高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者的NIHSS评分均低于治疗前,而且研究组的NIHSS评分在溶栓后6、24 h和14 d后均显著低于对照组,差异均有统计学意义(均P<0.05)。治疗后14 d,两组患者的BI指数均高于治疗前,而且研究组的BI指数显著高于对照组,差异均有统计学意义(均P<0.05)。两组患者的出血发生率比较,差异无统计学意义(P>0.05)。结论急性脑梗死行DSA引导下超选择性动脉溶栓的疗效显著优于尿激酶静脉溶栓治疗,患者的神经功能恢复良好,减少了致残率,提高了患者的生活质量。Objective The purpose is to discuss the efficacy and safety of traditional urokinase intravenous thrombolysis and DSA guided catheter super-selective injection of urokinase into responsible vessels in patients with hyperacute cerebral infarction.Methods 120 patients with acute cerebral infarction treated in our hospital from July 2015 to May 2020 were randomly divided into study group and control group.In the study group,60 cases underwent direct super-selective urokinase arterial thrombolysis in the responsible vessel after DSA,while in the control group,another 60 cases underwent traditional urokinase intravenous thrombolysis.Then the curative effect,NIHSS score before thrombolysis,6 hours,24 hours and 14 days after thrombolysis,Bi index before and 14 days after treatment,and the incidence of bleeding after treatment were compared between the two groups.Results The curative effect of the study group was significantly higher than that of the control group(P<0.05).The NIHSS scores of the two groups were lower than those before treatment,while the NIHSS scores of the study group were significantly lower than those of the control group 6 hours,24 hours and 14 days after thrombolysis(P<0.05 for each).The Bi index of the two groups was higher than that before thrombolysis treatment,while the Bi index of the study group was significantly higher than that of the control group before and 14 days after treatment(P<0.05 for both).There was no significant difference in the incidence of bleeding between the two groups(P>0.05).Conclusion The curative effect of super-selective arterial thrombolysis guided by DSA is significantly better than that of traditional urokinase thrombolysis.Supers-elective arterial thrombolysis is obviously better for the recovery of neurological function,reducing disability rate and improving quality of life.

关 键 词：尿激酶 静脉溶栓 DSA 动脉溶栓 

分 类 号：R743.33[医药卫生—神经病学与精神病学]