CT灌注指导下发病超过6h的前循环缺血性脑卒中患者行动脉溶栓治疗的临床效果观察

Clinical Observation of Arterial Thrombolysis Therapy for Patients with Ischemic Stroke in Anterior Circulation after Onset of 6 h Based on CT Perfusion

目的:探析在CT灌注指导下对发病时间>6 h的前循环缺血性脑卒中患者进行动脉溶栓治疗的效果。方法:回顾性分析本院2005年12月-2013年12月收治的发病时间>6 h的前循环缺血性脑卒中患者40例的临床资料,并与发病时间≤6 h的40例患者进行对比,两组患者均在CT灌注指导下行动脉溶栓治疗,比较有效性和安全性。结果:观察组治疗有效率为77.5%(31/40),对照组为87.5%(35/40);观察组治疗后NIHSS评分(7.1±2.4)分,对照组为(7.7±2.5)分;观察组血管再通良好率为90.0%(36/40),对照组为80.0%(32/40),观察组颅内出血率为27.5%(11/40),对照组为32.5%(13/40),观察组90 d内死亡率为15.0%(6/40),对照组为7.5%(3/40),比较差异均不具有统计学意义(P>0.05)。结论:在CT灌注指导下对发病时间>6h的前循环缺血性脑卒中患者进行动脉溶栓治疗安全有效。

Objective：To study the curative effects of arterial thrombolysis therapy for patients with ischemic stroke in anterior circulation after onset of 6 h based on CT perfusion.Method：80 patients with ischemic stroke in anterior circulation treated in our hospital from December 2005 to December 2013 were selected and divided into observation group（〉6 h） and control group（≤6 h） according to the time of attack,40 cases each group.Based on CT perfusion,two groups were given arterial thrombolysis therapy and the effectiveness and safety were compared.Result：The total effective rate of the observation group was 77.5%（31/40）and the control group was 87.5%（35/40）.NIHSS of the observation group was （7.1±2.4） and control group was （8.7±2.5）.The vascular recanalization rate of observation group and control group was 90.0%（36/40）and 80.0%（32/40）.The rate of intracranial hemorrhage of observation group and control group was 27.5%（11/40）and 32.5%（13/40）.The death rate of observation group and control group within 90 d was 15.0%（6/40）and 7.5%（3/40）.These differences were not significantly different（P〉0.05）.Conclusion：For patients with ischemic stroke in anterior circulation after onset of 6 h based on CT perfusion,the arterial thrombolysis therapy is safe and effective.