中国卒中杂志2017，Vol.12Issue(10)：906-910,5.DOI:10.3969/j.issn.1673-5765.2017.10.005
后循环脑梗死急诊溶栓的影响因素分析
Analysis of Influence Factors of Emergency Thrombolysis in the Posterior Circulation Cerebral Infarction
崔世磊 1南海天 1孔秀云 1江汉秋 1张晓君 1王佳伟1
作者信息
- 1. 100730 北京 首都医科大学附属北京同仁医院神经内科
- 折叠
摘要
Abstract
Objective The study aimed to analyze the major reason for thrombolysis rate in acute posterior circulation infarction (PCI). Methods Retrospective analysis was made based on acute PCI patients admitted in emergency department of neurology from June 2014 to June 2016. Patients with onset time less than 3.5 hours were included. The clinical data of thrombolysis and the reasons for not receiving thrombolysis were analyzed. Results A total of 67 acute PCI patients were retrospectively analyzed, and 25 patients with mean age 64.6±11.9 years old met the inclusion criteria were enrolled in the study. Among which, there were 64% males (16/25). Only 7 (28%) patients received recombinant tissue plasminogen activator (rt-PA) thrombolysis and 18 didn't receive thrombolysis. The National Institute of Health Stroke Scale (NIHSS) scores was significantly higher in the thrombolysis group (Median 6, interquartile range: 5-13) than that of non-thrombolysis group (Median 1, interquartile range: 0.75-2) (P=0.007). The door to all thrombolysis evaluation finish time of non-thrombolysis group was significantly longer than thromblysis group(90.3±30.8 minutes vs.71.4±13.8 minutes,P=0.046). The symptom onset to Emergency department arrival interval was not significantly different in both groups(140.7±48.5 minutes vs. 144.7±56.4 minutes,P=0.87).The median NIHSS score of non-thrombolysis group was 1 (interquartile range: 0-3.25) on one week follow up, and no significant difference was found when compared with the first evaluation (P=0.125), despite of aggravation in 6 patients (33.3%). Conclusion Prehospital delay was still an important reason influencing the rate of acute PCI thrombolysis. NIHSS score underestimated the condition of the patients with PCI, and insufficient attention to the opportunity of minor stroke thrombolysis were major reasons for the delay of door to needle time, which lead to the low rate of thrombolysis in acute minor PCI.关键词
急性后循环脑梗死/静脉溶栓/美国国立卫生研究院卒中量表Key words
Acute posterior cerebral infarction/Intravenous thrombolysis/National Institutes of Health Stroke Scale引用本文复制引用
崔世磊,南海天,孔秀云,江汉秋,张晓君,王佳伟..后循环脑梗死急诊溶栓的影响因素分析[J].中国卒中杂志,2017,12(10):906-910,5.
