rt-PA溶栓治疗在早期脑梗死中的应用研究

rt-PA Thrombolysis Therapy in Cerebral Infarction

目的:探讨rt-PA溶栓治疗早期脑梗死的临床疗效。方法:选择自2013年3月到2014年4月入院的72例病人,随机分成2组,实验组36例溶栓治疗,对照组36例传统治疗。实验组治疗方法为阿替普酶5 mg+生理盐水10 m L静脉缓慢推注,余下0.7mg/Kg+0.9%氯化钠注射100 m L 60 min滴完。对研究对象进行治疗90天,行临床神经功能评分和Barthel指数测定,卒中复发率比较。结果:治疗90天,总有效率:实验组91.67%,对照组72.22%;ESS神经功能评分:实验组89.13±4.58,对照组67.24±6.37;Barthel指数:实验组86.53±4.29,对照组50.45±6.69;一年后卒中复发率:实验组19.4%,对照组36.1%;实验组与对照组相比有显著性差异(P<0.05);实验组出现2例脑出血;经治疗90天病死率:实验组:2.78%,对照组2.78%,二组无差异(P>0.05)。结论:重组型组织型纤溶酶原激活剂(rt-PA)在脑梗死早期治疗中起到重要的治疗效果,可改善病人的致残率,加快神经功能缺损恢复,值得临床推广。

Objective： To investigate the clinical curative effect of rt-PA thrombolysis treatment for the early cerebral infarction. Methods： 72 cases were selected from March 2013 to April 2013, then they are randomly divided into 2 groups, experimental group and~ control group, 36 cases in each group. The patients in control group were treated by traditional methods. The patients in experimental group was treated with thrombolysis therapy by pushing note rt-PA 5 mg mixed by saline 10 mL in vein slowly, the remaining（0.7 mg/Kg ± 0.9 % sodium chloride in 100 mL） are injected and dripped offin 60 minutes. Clinical nerve function defect in 90 days, Barthe index, the recurrence rate of stroke are scored. Results： Treatment for 90 days, the total effective rate was 91.67 % in the experimental group, while it was 72.22 % in the control group; the ESS nerve function score was 89.13 ± 4.58, 67.24± 6.37 in the experimental group and control group respectively; the Barthel index in the experimental group was 86.53± 4.29, and 50.45± 6.69 in the control group; A year later the recurrence rate of stroke in the experimental group was 19.4 %, while 36.1% in control group; all above this had a significant difference between the experimental group and control group （P〈0.05）. In the experimental group, there were 2 cases of cerebral hemorrhage, and got better after treatment; 90 days after treatment, the morality rate had no difference in both groups with 2.78 %. Conclusions： rt-PA has an important effect on the early cerebral infarction treatment, can improve patient morbidity and speed up the recovery neurologic deficits, worthy of clinical promotion.