经颅超声联合溶栓治疗对急性缺血性脑卒中患者血管再通的作用

Effects of transcranial ultrasound combined with thrombolytic therapy on the recanalization of patients with acute ischemic stroke

目的探讨经颅超声联合溶栓治疗对于急性缺血性脑卒中患者血管再通的作用。方法收治的40例急性缺血性脑卒中患者随机分为经颅超声组和溶栓治疗组,2组患者均给予尿激酶溶栓治疗,经颅超声组患者在此基础上给予经颅超声治疗,采用经颅多普勒超声、美国国立卫生所脑卒中量表(NIHSS)于治疗前、治疗后2h、治疗后24h评估患者,并于治疗后3个月评价患者预后良好改良Rankin评分≤2分的发生率,治疗后采用CT评估患者并发脑出血情况。结果经颅超声组患者治疗后2h、24h血管再通率分别为45.0%、55.0%,显著高于溶栓治疗组的15.0%、20.0%再通率(P<0.05);治疗后2h、治疗后24h经颅超声组NIHSS评分分别为(10.6±2.8)分、(10.1±2.6)分,显著低于溶栓治疗组(13.9±3.3)分、(13.1±3.2)分的NIHSS评分(P<0.05);经颅超声组预后良好发生率为65.0%,显著高于溶栓治疗组20%(P<0.05);2组患者脑出血发生率差异无统计学意义(P>0.05)。结论在传统尿激酶溶栓治疗的基础上给予经颅脉冲超声治疗,能够显著提高血管再通率,改善患者预后,值得临床推广应用。

Objective To investigate the effects of transcranial ultrasound combined with thrombolytic therapy on the recanalization of patients with acute isehemic stroke. MethOds Forty patients with acute ischemic stroke in our hospital were divided into thromholytie therapy group （treated with urokinase） and transcranial ultrasound group （treated with urokinase plus transcranial ultrasound）. The curative effect of two groups were evaluated by the transeranial Doppler ultrasound and U. S. National Health Center stroke Scale （NIHSS） before treatment and 2 h, 24 h after treatment. The patients prognosis was assessed with Rankin score and the cerebral hemorrhage condition of patients were evaluated by using CT. Results 2 h and 24 h after treatment, the blood vessel recanalization rates of transcranial ultrasound group （45.0% and 55.0%） were higher than these of thrombolytic therapy （15.0% and 20.0%） group, and the NIHSS scores of transeranial ultrasound group （10.6±2.8, 10.1±2.6） points were lower than these of thrombolytic therapy group （13.9±3.3, 13.1±3.2） points. The good prognosis incidence of transcranial ultrasound group （65.0 %） was better than that of thrombolytic therapy group （20.0%）. There was no statistical difference in the cerebral hemorrhage rate between two groups. Conclusion Urokinase plus transcranial ultrasound can significantly increase the Mood vessel recanalization rate and improve patients prognosis, which is worthy of application.