阿替普酶联合机械取栓对急性脑梗死患者血流灌注及认知功能障碍的影响分析OA
Analysis of the Effects of Alteplase Combined with Mechanical Thrombectomy on Blood Perfusion and Cognitive Dysfunction in Patients with Acute Cerebral Infarction
目的:探讨阿替普酶联合机械取栓对急性脑梗死患者血流灌注及认知功能障碍的影响.方法:回顾性分析 2022年 11月—2024年 10月烟台市蓬莱中医医院收治的 78例急性脑梗死患者资料,根据治疗方案不同将其分为对照组及研究组,各 39例.对照组采用阿替普酶注射液溶栓治疗,研究组在对照组基础上采用机械取栓治疗.对比两组神经认知功能、脑血流速度指标、血流灌注情况及血流动力学指标.结果:治疗后,研究组的美国国立卫生研究院卒中量表评分为(6.94±1.35)分,低于对照组的(8.63±1.48)分,蒙特利尔认知评估量表评分为(26.04±0.57)分,高于对照组的(24.14±0.88)分,差异均有统计学意义(P<0.05).治疗后,研究组的大脑中动脉收缩期峰值流速、舒张期末流速均快于对照组,差异均有统计学意义(P<0.05).治疗后,研究组的脑血容量、脑血流量均大于对照组,脑血流平均通过时间短于对照组,差异均有统计学意义(P<0.05).治疗后,研究组的红细胞压积、纤维蛋白原、红细胞聚集指数均低于对照组,差异均有统计学意义(P<0.05).结论:采用阿替普酶联合机械取栓治疗急性脑梗死能有效提升患者的神经认知水平,改善脑部血流速度及血流动力学指标,有效促进其脑部血流灌注.
Objective:To explore the effects of alteplase combined with mechanical thrombectomy on blood perfusion and cognitive dysfunction in patients with acute cerebral infarction.Methods:The data of 78 patients with acute cerebral infarction admitted to Yantai Penglai Traditional Chinese Medicine Hospital from November 2022 to October 2024 were retrospectively analyzed.According to the different treatment plans,they were divided into a control group and a study group,with 39 cases in each group.The control group was treated with thrombolysis with alteplase injection,while the study group was treated with mechanical thrombectomy on the basis of the control group.The neurocognitive functions,cerebral blood flow velocity indicators,blood perfusion conditions and cerebral hemodynamic indicators of the two groups were compared.Results:After treatment,the National Institutes of Health Stroke Scale score in the study group was(6.94±1.35)points,which was lower than(8.63±1.48)points in the control group,and the Montreal Cognitive Assessment score was(26.04±0.57)points,which was higher than(24.14±0.88)points in the control group,the differences were statistically significant(P<0.05).After treatment,the peak systolic blood flow velocity and end diastolic velocity of the middle cerebral artery in the study group were faster than those in the control group,the differences were statistically significant(P<0.05).After treatment,the cerebral blood volume and cerebral blood flow in the study group were greater than those in the control group,and the mean transit time of cerebral blood flow was shorter than that in the control group,the differences were statistically significant(P<0.05).After treatment,the hematocrit,fibrinogen and red blood cell aggregation index of the study group were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The treatment of acute cerebral infarction with alteplase combined with mechanical thrombectomy can effectively enhance the neurocognitive level of patients,improve cerebral blood flow velociey and hemodynamic indicators,effectively promote cerebral blood perfusion.
宋义军
山东省烟台市蓬莱中医医院脑病一科,山东 烟台 264000
医药卫生
急性脑梗死阿替普酶机械取栓静脉溶栓血流灌注认知功能障碍
Acute cerebral infarctionAlteplaseMechanical thrombectomyIntravenous thrombolysisBlood perfusionCognitive impairment
《中国伤残医学》 2025 (10)
37-41,5
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