中国现代医生2024，Vol.62Issue(16)：33-37,45,6.DOI:10.3969/j.issn.1673-9701.2024.16.009
不同治疗时机静脉溶栓联合血管内治疗急性缺血性脑卒中患者的疗效
Efficacy of intravenous thrombolysis combined with intravascular therapy in patients with acute ischemic stroke at different treatment times
摘要
Abstract
Objective To compare the efficacy of intravenous thrombolysis combined with intravascular therapy for patients with acute ischemic stroke(AIS)from different treatment opportunities and its impact on prognosis.Methods A total of 180 AIS patients admitted to Wenzhou Central Hospital from July 2021 to September 2023 were selected as study objects,and divided into group A(thrombolysis within 2h),Group B(thrombolysis within 2-3h),group C(thrombolysis within 3-4.5h),group D(thrombolysis within 4.5-6h)and group E(thrombolysis within 6-9h)according to different thrombolysis times after owset.There were 36 cases in each group.All patients received alteplase intravenous thrombolysis combined with intravascular therapy.Vascular recanalization,neurological function,prognosis,ability of daily living and complications were compared among all groups.Results Vascular recanalization rate of five groups had statistical significance(χ2=11.500,P=0.022).Vascular recanalization rate of group E was significantly lower than that of other four groups(P<0.05),and vascular recanalization rate of group D was significantly lower than that of groups A,B and C(P<0.05).After thrombolysis,National Institutes of Health stroke scale(NIHSS)score and modified Rankin scale(mRS)score of patients in all groups were significantly decreased with the extension of time(P<0.05).At different time after thrombolysis,NIHSS score and mRS score in group E were significantly higher than those in other four groups,and NIHSS score and mRS score in group D were significantly higher than those in groups A,B and C(P<0.05).After thrombolysis,Barthel index(BI)of all groups increased significantly with the extension of time(P<0.05).At different time after thrombolysis,BI score of group E were significantly lower than those of other four groups,and BI score of group D were significantly lower than those of groups A,B and C(P<0.05).Within 90 days after thrombolysis,there was no significant difference in the incidence of intracranial hemorrhage,oral hemorrhage,nosocomial infection and cerebral hernia among five groups(χ2=1.356,P=0.852).Conclusion Alteplase intravenous thrombolysis combined with intravascular therapy in AIS patients within 4.5h has better clinical efficacy and better prognosis.关键词
阿替普酶/急性缺血性脑卒中/静脉溶栓/血管内治疗Key words
Alteplase/Acute ischemic stroke/Intravenous thrombolysis/Intravascular therapy分类
医药卫生引用本文复制引用
潘学威,李志伟,朱荷燕,茅新蕾,黄向东..不同治疗时机静脉溶栓联合血管内治疗急性缺血性脑卒中患者的疗效[J].中国现代医生,2024,62(16):33-37,45,6.基金项目
浙江省温州市基础科研项目(Y20220826) （Y20220826）
