rt—PA静脉溶栓治疗急性缺血性脑卒中的临床疗效观察.docVIP

rt—PA静脉溶栓治疗急性缺血性脑卒中的临床疗效观察 　　[摘要] 目的 探讨重组组织型纤溶酶原激活剂（rt-PA）静脉溶栓治疗急性缺血性脑卒中的临床疗效和安全性。方法 将我院急诊科收治的缺血性脑卒中138例患者随机分为rt-PA溶栓治疗组和对照组，在给予抗血小板聚集、降低颅内压、改善微循环和脑保护剂的基础上，对照组静脉滴注低分子肝素钠，治疗组给予rt-PA溶栓治疗，比较两组的神经功能缺损（NIHSS）评分、日常生活活动能力的Barthel指数（BI）和不良反应发生率。结果 治疗前两组的NIHSS评分与BI没有显著性差异（P 0.05），经过两个疗程治疗后，溶栓治疗组的总有效率为95.7%，显著高于对照组的75.0%，NIHSS评分和BI显著优于对照组（P 0.05），两组不良反应发生率无显著性差异。结论 rt-PA静脉溶栓治疗急性缺血性脑卒中具有较好的临床疗效，可改善患者的临床症状和预后，提高患者的生活质量和满意度，安全性好，值得临床推广使用。 　　[关键词] 重组组织型纤溶酶原激活剂；静脉溶栓治疗；急性缺血性脑卒中 　　[中图分类号] R743.32 [文献标识码] B [文章编号] 1673-9701（2013）36-0054-04 　　Clinical effect observation of intravenous thrombolysis of recombinant tissue plasminogen activator （rt-PA） on acute ischemic stroke 　　TENG Xusheng1 CHENG Qiantao2 　　1.Department of Emergency， Jinhua Municipal Central Hospital in Zhejiang Province， Jinhua 321000， China ；2.Department of Internal Medicine， Huaian First Peoples Hospital of Jiangsu Province， Huaian 223300， China 　　[Abstract] Objective To explore the clinical effects and safety of intravenous thrombolysis of recombinant tissue plasminogen activator （rt-PA） treatment on acute ischemic stroke （AIS）. Methods A total of 138 qualified patients of AIS were divided as therapy group and control group randomly. On the basis of treatment includedg anti-platelet aggregation， reducing intracranial pressure， improving microcirculation and brain protective agent， the patients of control group were treated with low molecular heparin through intravenous drip， the patients of therapy group were given thrombolysis of rt-PA treatment， instead. The National Institute of Health Stroke Scale（NIHSS） score and Barthel index （BI） were used to evaluate the neurological function and activities of daily living， respectively. Results No significant differences of NIHSS score and BI were observed between the therapy group and control group before the treatment（P0.05）. After treatment， the total effective rate， NIHSS score and BI of therapy group were significantly superior to the control group （P0.05）