扩大时间窗动、静脉联合溶栓治疗急性脑梗死的临床研究

Clinical study on expanding time window of arteriovenous thrombolysis in treatment of acute cerebral infarction

目的 探讨扩大时间窗动、静脉联合溶栓治疗急性脑梗死的临床效果。方法 回顾性分析2015年1月-2016年6月在我院神经内科接受治疗的60例急性脑梗死患者的临床资料,将其随机分成对照组与研究组,均30例。对照组行常规时间窗（发病时间在4.5 h之内）动、静脉联合溶栓治疗,研究组行扩大时间窗（发病4.5-10 h）动、静脉联合溶栓治疗。比较两组美国国立卫生院卒中（NIHSS）评分、日常生活活动能力量表-巴氏（BI）指数、并发症发生情况,评价两组临床疗效。结果 治疗前,治疗后7、14 d,两组NIHSS评分比较,差异无统计学意义（P〉0.05）;治疗后2、24 h,两组NIHSS评分比较,差异有统计学意义（P〈0.05）。治疗后14 d,两组临床疗效及并发症发生率比较,差异无统计学意义（P〉0.05）;治疗后28 d,两组BI指数比较,差异无统计学意义（P〉0.05）。结论 与常规时间窗动、静脉溶栓治疗相比,扩大时间窗动、静脉联合溶栓治疗急性脑梗死,同样可有效改善患者神经功能缺损情况,提高日常生活能力,且并发症发生率较低,疗效显著,值得推广。

Objective To investigate the clinical efficacy of expanding time window of arteriovenous thrombolysis in treatment of acute cerebral infarction （ACI）.Methods The clinical data of 60 ACI patients treated in the neurology department of hospital from January 2015 to June 2016 were retrospectively analyzed,and they were randomly divided into control group and research group,30 cases in each group.Control group took routine time window （onset time within 4,5 h） of arteriovenous thrombolysis;research group took expanding time window （onset time within 4.5-10 h） of arteriovenous thrombolysis.NIHSS,BI scores and occurrence of complications of two groups were .compared,and clinical efficacy of two groups were evaluated.Results Before treatment,7 d and 14d after treatment,there was no statistical difference in NIHSS scores compared between the two groups （P〉0.05）;after treatment 2, 24 h,the NIHSS score of two groups was compared,the difference was statistically significant （P〈0.05）.14 d after treatment,there was no statistical difference in clinical efficacy and incidence of complications compared between the two groups （P〉0.05）;28 d after treatment,there was no statistical difference in BI compared between the 4wo groups （P〉0.05）.Condusion Compared with routine time window of arteriovenous thrombolysis,expanding time window of arteriovenous thrombolysis for treating ACI equally can effectively improve patients＇ neurologic impairment and increase activity of daily living,it has low incidence of complications and significant efficacy,which is worthy of generalization.