院前亚低温结合院内溶栓救治急性脑梗死的效果  

Application of pre-hospital mild hypothermia combined with thrombolysis in treatment of acute cerebral infarction

作　　者：潘鑫 黄晓云 王超 顾慧 唐加波 王鹏 崔恒熙 李政 Xin Pan;Xiaoyun Huang;Chao Wang;Hui Gu;Jiabo Tang;Peng Wang;Hengxi Cui;Zheng Li(Department of First-Aid,Zhenjiang Emergency Center,Zhenjiang 212003,China;Department of Emergency,Zhenjiang First People's Hospital,Zhenjiang 212001,China)

机构地区：[1]镇江市急救中心急救科,江苏镇江212003 [2]镇江市第一人民医院急诊科,江苏镇江212001

出　　处：《中华卫生应急电子杂志》2024年第3期145-148,共4页Chinese Journal of Hygiene Rescue(Electronic Edition)

基　　金：2022年度镇江市科技创新资金(重点研发计划--社会发展)项目(SH2022103)。

摘　　要：目的探讨从院前应用亚低温疗法联合院内静脉溶栓对急性脑梗死(ACI)患者救治的效果。方法选取2022年1月至2023年6月镇江市急救中心在院前急救现场将初步判断为急性脑卒中的患者送往医院进行救治,最终经过确诊为ACI的患者78例,通过回顾性研究分为观察组38例和对照组40例。对照组患者接受常规的院前急救措施,观察组患者在院前即开始实施亚低温治疗,两组患者到达院内后均采用阿替普酶静脉溶栓治疗。比较两组患者的美国国立卫生研究院卒中量表评分(NIHSS)、日常生活活动能力量表(ADL)、超氧化物歧化酶(SOD)和丙二醛(MDA)水平。结果治疗2周后观察组患者NIHSS评分、ADL评分、SOD水平、MDA水平均优于对照组患者,差异均有统计学意义(P<0.05)。结论院前对ACI患者开始的亚低温治疗,结合静脉溶栓治疗能减轻ACI患者的氧化应激反应,改善患者预后。Objective To investigate the effect of mild hypothermia therapy combined with intravenous thrombolysis in the treatment of patients with acute cerebral infarction(ACI)from pre-hospital.Methods From January 2022 to June 2023,Zhenjiang Emergency Center sent patients who were initially diagnosed as stroke to the hospital for treatment at the pre-hospital emergency site.Finally,78 patients who were diagnosed as acute cerebral infarction were randomly divided into observation group(38 cases)and control group(40 cases).The patients in the control group received routine pre-hospital emergency measures,and the patients in the observation group began to implement mild hypothermia treatment before the hospital.The patients in the two groups were treated with alteplase intravenous thrombolysis after reaching the hospital.The National Institutes of Health Stroke Scale(NIHSS)score,activities of daily living scale(ADL),superoxide dismutase(SOD)and malondialdehyde(MDA)levels were compared between the two groups.Results After 2 weeks of treatment,the NIHSS score,ADL score,SOD level and MDA level in the observation group were better than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion Pre-hospital mild hypothermia therapy combined with intravenous thrombolysis significantly reduces the oxidative stress response and improves the prognosis for patients with acute cerebral infarction.

关 键 词：亚低温 静脉溶栓 阿替普酶 急性脑梗死 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]