急性脑梗死的溶栓治疗.pdfVIP

上海交通大学 硕士学位论文 急性脑梗死的溶栓治疗 姓名：张彬 申请学位级别：硕士 专业：神经内科 指导教师：孙晓江 上海交通大学 2005 级硕士学位论文  等级为 III 级的，预后良好的 58.3％；再通等级为 II 级的，预后良好 的25％。 3. 动静脉溶栓的比较：静脉组和动脉组疗效和安全性的比较无差 异（P0.05）。大脑中动脉闭塞，静脉溶栓预后良好的占 38.8％，动脉 溶栓预后良好的占 46.2％。 结论： 1.静脉溶栓预后同年龄、治疗时间窗无关。房颤病人的出血率和死 亡率较高。 2.动脉溶栓血管的再通率和闭塞的部位与预后有关。 3.动脉溶栓和静脉溶栓的疗效和安全性没有差异，大脑中动脉闭塞， 动脉溶栓效果较好。 关键词：急性脑梗死，rt-PA,溶栓                          上海交通大学 2005 级硕士学位论文  THROMBOLYSIS FOR THE ACUTE ISCHEMIC STROKE   ABSTRACT   Objective: To investigate the efficacy and safety of thrombolysis, and to compare the outcome and the safety between the intravenous and intra-arterial thrombolysis, and analysis the factors related to the outcome. Methods: 110 cases of acute ischemic stroke patients were treated with rt-PA. Comparing the scores of the NIHSS and ESS before and after thrombolysis, to evaluate the safety and efficiency of thrombolysis ，using mRS to evaluate the prognosis after three month of thrombolysis. Results: 1. Intravenous thrombolysis: the patients with good outcome were 45.6%, the incidence of the SICH was 6.7%, and the death rate was 13.3%. The patients’ age and the time window had no relation with the safety of thrombolysis. The effeciency of affiliated patients was similar to the non-affiliated patients, but affiliated patients had higher bleeding rate and death rate. The baseline NIHSS core