CT评价指导的觉醒型缺血性卒中患者的静脉溶栓预后效果

Efficacy of intravenous thrombolysis in patients with awakening ischemic stroke by the CT evaluation

目的:探讨CT评价指导的觉醒型缺血性卒中(WUS)患者的静脉溶栓预后效果。方法:采用回顾性研究方法,以2013-02-2016-01在神经内科就诊的WUS患者120例为研究对象,均进行头部CT检查,判断静脉溶栓的入选对象。纳入溶栓治疗的患者都给予rt-PA静脉溶栓治疗,没有纳入溶栓治疗的患者均给予常规治疗,观察2组预后情况。结果:经过CT快速评价指导,120例患者中有40例进行静脉溶栓治疗(观察组),80例患者没有进行静脉溶栓治疗(对照组),2组rCBV值比较差异无统计学意义。观察组的rCBF与rMTT值与对照组比较差异有统计学意义(P<0.05)。观察组的治疗有效率为97.5%,对照组为81.3%,观察组的明显高于对照组(P<0.05);观察组的症状性脑出血发生率也明显少于对照组(P<0.05)。结论:CT评价指导下筛选出部分觉醒型缺血性卒中进行溶栓治疗能促使脑血流尽早恢复灌注,挽救缺血半暗带,有利于改善预后。

Objective：To evaluate the efficacy of intravenous thrombolysis in patients with awakening ischemic stroke（WUS）by the CT evaluation.Method：Used a retrospective study,120 patients with WUS who were selected in our hospital from January 2016 to February 2013 as the study subjects.All patients were treated with head CT examination.Patients were selected thrombolysis were treated with rt-PA intravenous thrombolytic therapy,and patients were not selected thrombolytic were given conventional treatment,and the prognosis of the two groups were observed.Result：After fast CT evaluation guidance,120 patients with 40 patients were selected intravenous thrombolytic（the observation group）,80 patients were not selected intravenous thrombolytic therapy（the control group）.Two groups of rCBV value compared were no significant difference.However,the rCBF and rMTT values in observation group compared to the control group difference were significant（P〈0.05）.The effective rate of observation group was 97.5%,the control group was 81.3%,the observation group was significantly higher than that of the control group（P〈0.05）,while the incidence of symptomatic cerebral hemorrhage in the the observation group was significantly less than that of the control group（P〈0.05）.Conclusion：The intravenous thrombolysis in patients with awakening ischemic stroke by the CT evaluation can restore perfusion and save the ischemic semi dark band,which can lead to the early recovery of the cerebral blood flow,it is conducive to improve the prognosis.