院前和院内延迟溶栓急救急性卒中患者的研究分析

Research Analysis of Pre and In-Hospital and Delayed Emergency Thrombolytic Therapy for Patients with Acute Apoplexia

目的:探讨院前和院内延迟溶栓急救急性卒中患者的原因与临床效果,为推广溶栓急救提供参考。方法:急性脑卒中160例表现为院前延迟溶检急救的有100例(对照组),表现为院内延迟溶栓急救的为80例(观察组),两组都采用rt-PA溶栓治疗,观察两组院前和院内延迟溶检急救的原因,同时对两组治疗前后血清IL-6、TNFα水平,NIHSS评分的变化与安全性进行观察。结果:对照组表现多为22点到早上6点发病,120到达时间比较慢;观察组表现多为院内处理时间慢。两组治疗前血清IL-6、TNFα水平无明显差异(P>0.05),经过治疗后,两组血清IL-6、TNFα水平有所下降(P<0.05),但观察组治疗24小时后下降程度大于对照组组,两组差异有显著性(P<0.05)。治疗前两治疗组患者NIHSS评分的水平均有升高,但两组之间无显著性差异(P>0.05),治疗后NIHSS评分均有一定程度改善,但观察组在治疗后2小时、24小时、7d的NIHSS评分与对照组比较有差异(P<0.05)。且随着治疗时间的延长,观察组NIHSS评分改善的幅度逐浙加大。两组均无死亡病例,两组安全性对比无统计学差异(P>0.05)。结论:及时溶栓治疗能有效改善IL-6、TNFα水平,降低NIHSS评分,同时安全性好。为此为提高溶检治疗率,应教育患者发病后尽快到达有条件进行溶栓的医院,完善医院内溶栓治疗的绿色通道。

Objective： To explore cause and clinical effect ofpre and in-hospital and delayed emergency thrombolytic therapy lbr patients with acute apoplexia fbr the reference of promoting emergency thrombolytic therapy. Methods： Among all the 160 patients with acute apoplexia, 100 cases （Control Group） were treated with pre-hospital delayed thrombolytic therapy; the other .80 cases （Observation Group） were treated with in-hospital delayed thrombolytic therapy. Both received rt-PA thrombolytic therapy to observe causes for their separate treatments; meanwhile, variation and safety of IL-6,