急诊溶栓结合分组定位救治对急性缺血性脑卒中患者血液流变学及神经损伤因子的影响OACSTPCD
Effect of emergency thrombolysis combined with group-oriented treatment on hemorheology and nerve injury factors in patients with acute ischemic stroke
目的 分析急性缺血性脑卒中患者实施急诊溶栓结合分组定位救治的效果.方法 按随机对照原则,将2020-08-2021-08连云港市第一人民医院收治的90例急性缺血性脑卒中患者分为观察组(45例,实施急诊溶栓结合分组定位救治)和对照组(45例,接受常规治疗及干预措施).比较2组患者出院时临床疗效、抢救时间(入院至CT检查时间、CT检查结束至开始溶栓时间),观察治疗前、治疗后7d血液流变学指标、神经损伤因子水平.随访6个月,比较2组患者治疗前、干预6个月后的日常生活能力.结果 观察组总有效率较对照组高,抢救时间较对照组短(P<0.05).观察组治疗后血小板黏附率、血小板最大聚集率、高切全血黏度、S-100β蛋白、神经元特异性烯醇化酶(NSE)、基质金属蛋白酶9(MMP-9)均相比对照组更低(P<0.05).观察组随访6个月后的BI评分较对照组高(P<0.05).结论 急诊溶栓结合分组定位救治能够有效缩短急救时间,利于降低急性缺血性脑卒中患者神经损伤因子水平,调节血液流变学,提升日常生活能力,临床疗效较好.
Objective To analyze the effect of emergency thrombolysis combined with group localization in acute ischemic stroke patients.Methods According to the principle of random control,90 patients with acute ischemic stroke admitted to Lianyungang First People's Hospital from August 2020 to August 2021 were divided into observation group(45 cases,treated by emergency thrombolysis combined with group-oriented treatment)and control group(45 cases,treated with routine treatment and intervention measures).The clinical efficacy and rescue time(from admission to CT,from the end of CT examination to the start of thrombolysis)were compared between the two groups,and the hemorheological indexes and nerve injury factors were observed before treatment and 7 days after treatment.Followed-up for 6 months,the activities of daily living between the two groups before treatment and after 6 months of intervention were compared.Results The observation group exhibited a better overall effective rate and a shorter rescue time compared to the control group(P<0.05).After treatment,the whole blood viscosity,platelet adhesion rate,maximum platelet aggregation rate,S-100β protein,neuron-specific enolase(NSE)and matrix metalloproteinase-9(MMP-9)in the observation group were lower than those in the control group(P<0.05).Following a 6-month of observation,the observation group's BI index was greater than that of the control group(P<0.05).Conclusion Emergency thrombolysis combined with group-oriented treatment can effectively shorten the first aid time,improve the hemorheology index of patients with acute ischemic stroke,reduce the level of nerve injury factors,improve the ability of daily living,and have better clinical effect.
张晓;倪佃丽;相婷婷;颜虹杰;于杰
连云港市第一人民医院,江苏 连云港 222000
临床医学
急性缺血性脑卒中急诊溶栓分组定位救治危机管理神经损伤因子
Acute ischemic strokeEmergency thrombolysisGroup-oriented treatmentCrisis manage-mentPrognosisNeurological function
《中国实用神经疾病杂志》 2024 (008)
961-965 / 5
江苏省优势学科建设工程项目(编号:YSHL0720-33)
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