摘要
目的观察组织型纤溶酶原激活剂(rt-PA)动脉溶栓联合机械取栓治疗急性缺血性脑梗死(acute cerebral infarction,ACI)的效果。方法选取符合纳入及排除标准的ACI 105例,将给予rt-PA动脉溶栓联合机械取栓治疗的53例作为观察组,给予rt-PA动脉溶栓治疗的52例作为对照组。观察比较两组临床疗效、血管再通情况、神经功能缺损评分(NIHSS)、日常生活能力量表(ADL)评分、氨基末端B型尿钠肽前体(NT-proBNP)水平、D二聚体水平以及围术期不良反应发生情况。结果治疗后3个月,总有效率观察组为88.68%显著高于对照组69.23%,差异有统计学意义(P<0.05)。治疗后血管再通率观察组为84.91%显著高于对照组65.38%,差异有统计学意义(P<0.05)。治疗后3个月,两组NIHSS及NT-proBNP、D二聚体水平显著低于治疗前,ADL评分显著高于治疗前,差异有统计学意义(P<0.05)。治疗后3个月,观察组NIHSS及NT-proBNP、D二聚体水平显著低于对照组,ADL评分显著高于对照组,差异有统计学意义(P<0.05)。围术期观察组不良反应发生率为7.55%,对照组不良反应发生率为23.08%,观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论 rt-PA动脉溶栓联合机械取栓能够提高ACI患者临床治疗效果,增加血管再通率,提高神经功能和日常生活能力,改善NT-proBNP和D二聚体水平,且不良反应发生率较低。
Objective To observe the influence of rt-PA arterial thrombolysis combined with mechanical embolus removal in cerebral ischemia(MERCI)on short-term efficacy and long-term outcome of patients with acute ischemic cerebral infarction(ACI).Methods A total of 105 patients with ACI were enrolled in this study in accordance with the inclusion and exclusion criteria.Fifty-three patients were treated with rt-PA arterial thrombolysis combined with MERCI as observation group,and 52 were treated with rt-PA arterial thrombolysis at the same time as the control group.Clinical effect,recanalization rate,NIH Stroke Scale(NIHSS),Activity of Daily Living(ADL)Scale,N-terminal brain natriuretic peptide(NT-proBNP),D-dimer levels,and perioperative adverse reaction were observed in the two groups.Results Three months after treatment,the total effective rate in the observation group was 88.68%,significantly higher than that(69.23%)of the control group(P<0.05);the vascular recanalization rate in the observation group was 84.91%,which was significantly higher than that(65.38%)of the control group,and there were significant differences(P<0.05).Three months after treatment,NIHSS and levels of NT-proBNP and D-dimer in the two groups were significantly lower than those before treatment,while the ADL score was remarkably higher than that before treatment(P<0.05).In addition,the NIHSS score and the levels of NT-proBNP and D-dimer were significantly lower in the observation group than in the control group,and the ADL score was significantly higher than that in the control group,suggesting significant differences(P<0.05).The incidence of perioperative adverse reactions in the observation group was 7.55%,and the incidence of adverse reactions in the control group was 23.08%,which was lower in the observation group than in the control group(P<0.05).Conclusion Rt-PA arterial thrombolysis combined with MERCI can improve the clinical effect on ACI,increase the rate of vascular recanalization,improve neurological function and daily living ability as well as NT-proBNP and D-dimer levels,with a low incidence of adverse reactions.
作者
杨占辉
尹学敬
YANG Zhan-hui;YIN Xue-jing(Department of Interventional Therapy,Hengshui Harleison International Peace Hospital,Hengshui,Hebei 053000,China;Department of Obstetrics,Hengshui Harleison International Peace Hospital,Hengshui,Hebei 053000,China)
出处
《临床误诊误治》
2018年第8期45-49,共5页
Clinical Misdiagnosis & Mistherapy
基金
2015年度河北省医学科学研究重点课题计划(20150434)
