延长静脉溶栓时间窗治疗后循环进展型脑梗死分析.docVIP

延长静脉溶栓时间窗治疗后循环进展型脑梗死分析 　　摘要：目的 探?后循环进展型脑梗死延长静脉溶栓时间窗的治疗效果。方法 选择神经内科2012年9月～2015年7月通过MRIDWI 确诊为后循环脑梗死且在3～12 h出现进展（NIHSS评分增加2分）的CT 阴性的椎 -基底动脉梗死患者 52 例为本研究入组患者，随机分为试验组29例和对照组23例，且试验组根据溶栓开始时间分为3～6 h、6～9 h、9～12 h三个亚组，给予rt-PA 溶栓治疗，比较试验组和对照组NIHSS评分，Bathel指数和改良Rankin量表评分，记录不良事件。结果 本组29 例中静脉溶栓有效27 例 ，有效率93.10%。其中3～6 h内溶栓 12例，有效 12例；6～9 h 溶栓 9 例，有效 7例；9～12 h溶栓 8 例，有效6 例。这说明最佳的溶栓时间在 6 h内，但延长溶栓时间仍有一定的疗效。结论 后循环进展性脑梗死患者采用延长静脉时间窗（3～12 h）进行溶栓治疗效果理想，适当的延长rt-PA 静脉溶栓时间窗能提高临床效果，值得推广应用。 　　关键词：脑梗死；静脉溶栓；间窗 　　中图分类号：R473.3 文献标识码：A 文章编号：1006-1959（2017）17-0045-03 Analysis of Prolonged Intravenous Thrombolysis Time Window after Treatment of Circulating Progressive Cerebral Infarction 　　ZHANG Hong-mei1，DU Da-yong2，CHEN Shu-yuan1，LI Yuan-pei1，LI Shan-shan1，ZHANG Dong-ju1 　　（1.Department of Neurology，Tianjin Port Hospital，Tianjin 300456，China； 　　2.Department of Neurology，TEDA Hospital，Tianjin 300457，China） 　　Abstract：Objective To investigate the effect of prolonging the time window of thrombolytic therapy in patients with posterior circulation progressive cerebral infarction.Methods Select the Department of Neurology in September 2012 to July 2015，by MRIDWI confirmed the diagnosis of posterior circulation cerebral infarction and progress in 3～12 h（NIHSS score increased2 points）CT negative patients with vertebral basilar artery infarction in 52 cases for the study group patients were randomly divided into experimental group and control group of 29 cases in 23 cases，and the experimental group according to thrombolytic starting time divided into 3～6 h，6～9 h，9～12 h three sub group，given rt-PA thrombolytic therapy，the NIHSS score，the Bathel index and the modified Rankin scale score were compared between the experimental group and the control group，and adverse events were recorded.Results Among these 29 cases，27 cases were effectively treated with intravenous thrombolysis，with an effective rate of 93.2%.Among them， 12 cases were treated with thrombolysis within 3～6 h，and 12 cases were effective；