rt-PA静脉溶栓与超选择性动脉溶栓治疗急性大脑中动脉脑梗死临床分析

Clinical analysis of rt-PA intravenous thrombolysis and superselective arterial thrombolysis for acute middle cerebral artery cerebral infarction

目的探讨rt-PA静脉溶栓与超选择性动脉溶栓治疗急性大脑中动脉脑梗死的临床效果。方法分析巩义市人民医院2015-01—2018-02收治的240例急性大脑中动脉脑梗死患者的临床资料,依据治疗方式分为rt-PA静脉溶栓组210例和超选择性动脉溶栓组30例。观察2组不同时间点NIHSS评分、纤维蛋白原(FIB)、凝血酶原时间(PT)及凝血酶时间(TT)情况,对比2组血管再通率、总有效率。结果 2组溶栓前NIHSS评分、FIB、PT、TT比较,差异均无统计学意义(P>0.05),超选择性动脉溶栓组溶栓6 h、3 d、7 d NIHSS评分、PT、TT均低于rt-PA静脉溶栓组,FIB均高于rt-PA静脉溶栓组,超选择性动脉溶栓组血管再通率、总有效率均高于rt-PA静脉溶栓组,差异有统计学意义(P<0.05)。结论超选择性动脉溶栓治疗急性大脑中动脉脑梗死,患者神经功能和凝血功能改善,血管再通率、总有效率均较高。

Objective To investigate the clinical effect of rt-PA intravenous thrombolysis and superselective arterial thrombolysis in the treatment of acute middle cerebral artery cerebral infarction.Methods The clinical data of 240 patients with acute middle cerebral artery cerebral infarction admitted to Gongyi People's Hospital from January 2015 to Februay 2018 were analyzed.According to the treatment,210 patients with rt-PA intravenous thrombolysis and 30 patients with superselective arterial thrombolysis.The NIHSS score,fibrinogen(FIB),prothrombin time(PT)and thrombin time(TT)were observed at different time points in the two groups.The revascularization rate and total effective rate of the two groups were compared.Results There were no significant differences in NIHSS scores,FIB,PT and TT between the two groups before thrombolysis(P>0.05).The super selective arterial thrombolysis group was treated with TSH for 6h,3d,7d,NIHSS score,PT,TT was lower than rt-PA intravenous thrombolysis group,FIB was higher than rt-PA intravenous thrombolysis group,and the recanalization rate and total effective rate of superselective arterial thrombolysis group were higher than that of rt-PA intravenous thrombolysis group.The difference was statistically significant(P<0.05).Conclusion Superselective arterial thrombolysis is effective in the treatment of acute middle cerebral artery cerebral infarction.The neurological function and coagulation function are improved,and the recanalization rate and total effective rate are high.