急性脑梗死静脉溶栓治疗的临床分析

The clinical analysis of intravenous thrombolysis therapy in acute cerebral infarction patients

目的：通过对急性脑梗死静脉溶栓病例分析,探究阿替普酶（rt-PA）静脉溶栓的有效率及其影响因素。方法：回顾性分析发病6小时内使用rt-PA静脉溶栓的急性脑梗死患者26例,分析其疗效的影响因素。结果：26例溶栓病例的总有效率达65.38%;2h内、2~4.5h及4.5~6h内溶栓有效率分别为100%、53.3%及66.6%。溶栓前NIHSS评分4~10分者有效率为100%,11~20分者有效率为50%,20分以上者均无效（0%）;超过80岁溶栓有效率为60%;总的脑出血并发症发生率为11.53%。结论：急性脑梗死患者,溶栓时间窗越早,溶栓前NIHSS评分越低,预后越好;高龄不是静脉溶栓绝对禁忌症;溶栓后脑出血发生率较低。

Objective： Analyze the intravenous thrombolysis therapy in acute cerebral infarction patient, and explore the effective rates of alteplase（rt-PA） intravenous thrombolysis in acute cerebral infarction patients and its influencing factors. Methods： There were 26 cases of patients with acute cerebral infarction in 6 hours were retrospectively analyzed, and the influence factors were analyzed. Results： The total effective rates of thrombolysis was65.38% in 26 cases, the effective rate of thrombolysis within in 2 hours,2~4.5 hours and 4.5 ~ 6 hours was 100%,53.3% and 66.6% respectively, the effective rate of thrombolysis with 4 to 10 points,11 to 20 points, ≥20 points NIHSS cores before thrombolysis was 100%, 50%, and 0% respectively, the effective rate of thrombolytic was 60% in patients more than 80 years old; the rate of cerebral hemorrhage after thrombolytic was 11.53%. Conclusion： The earlier the thrombolytic and the lower the NIHSS score before thrombolysis, the better the long-term outcomes in acute cerebral infarction patients. Elderly patient is not the absolute contraindications of venous thrombolysis. The incidence of intracerebral hemorrhage is low after intravenous thrombolysis.