不同时间窗静脉溶栓干预对急性缺血性脑卒中患者预后的影响

Influence of Intravenous Thrombolysis at Different Time Window on the Prognosis of Patients with Acute Ischemic Stroke

目的探讨不同时间窗尿激酶静脉溶栓干预对急性缺血性脑卒中患者预后的影响。方法选取我院2014年7月至2016年7月期间收治的急性缺血性脑卒中患者162例,所有患者均采用尿激酶静脉溶栓治疗。根据治疗时间窗将其分为A组(治疗时间窗<3 h)、B组(治疗时间窗为3～6 h)和C组(治疗时间窗>6 h)。比较三组患者的治疗效果。结果治疗1d、2 d、3d、7 d、14 d后的ESS评分呈上升趋势,其中A、B组的ESS评分明显高于C组(P<0.05)。治疗14 d后,三组患者的死亡率比较无统计学差异(P>0.05),A组的总有效率明显高于C组(P<0.05)。结论发病3 h内和3～6 h采取尿激酶溶栓治疗急性缺血性脑卒中的临床疗效较好,预后良好,超过6h进行溶栓治疗的疗效和预后均不理想。

Objective To explore the influence of intravenous thrombolysis at different time window on the prognosis of patients with acute ischemic stroke. Methods 162 cases of patients with acute ischemic stroke admitted to our hospital from July 2014 to July 2016 were selected and given urokinase intravenous thrombolysis. They were divided into group A（treatment time window 〈3 h）, group B（treatment time window 3 ～ 6 h） and group C（treatment time window 〉 6 h） according to the treatment time window. The treatment effects of three groups were compared. Results The ESS scores 1 d, 2 d, 3 d, 7 d and 14 d after treatment were on an upward trend. The ESS scores of group A and group B were significantly higher than that of group C（P 〈0.05）. 14 d after treatment, no statistical difference was found among the three groups in the mortality（P 〉0.05）. The total effective rate of group A was significantly lower than that of group C（P 〈0.05）.Conclusions The clinical curative effect and prognosis of urokinase thrombolysis in the treatment of acute ischemic stroke within 3 h and 3 h to 6 h are better, and the clinical curative effect and prognosis of thrombolysis over 6 h are unsatisfactory.