不同时间窗rtPA静脉溶栓治疗急性脑梗死的临床效果

Clinical effect of intravenous thrombolysis with rtPA at different time windows in the treatment of acute cerebral infarction

目的研究不同时间窗rtPA静脉溶栓治疗急性脑梗死的临床效果。方法将2018年4月至2019年4月我院的40例急性脑梗死患者根据给药时间不同分为试验组(20例,发病至给药时间<3.0 h)和对照组(20例,发病至给药时间在3.0~4.5 h)。比较两组患者的临床治疗效果、治疗前、后mRS、NIHSS评分及不良反应发生情况。结果试验组的临床治疗总有效率为95.00%,显著高于对照组的65.00%,差异具有统计学意义(P<0.05)。治疗后,两组的mRS及NIHSS评分均降低,且试验组低于对照组,差异具有统计学意义(P<0.05)。试验组的上消化道出血及颅内出血发生率均低于对照组,差异具有统计学意义(P<0.05)。结论在临床采用rtPA静脉溶栓治疗急性脑梗死过程中,发病至给药时间<3.0 h时间窗治疗的疗效确切且安全。

Objective To study the clinical effect of intravenous thrombolysis with rtPA at different time windows in the treatment of acute cerebral infarction.Methods Forty patients with acute cerebral infarction in our hospital from April 2018 to April 2019 were divided into experimental group(20 cases,<3.0 hours from onset to administration)and control group(20 cases,3.0-4.5 hours from onset to administration)according to different administration time.The clinical treatment effect,the scores of mRS and NIHSS before and after treatment and adverse reactions were compared between the two groups.Results The total effective rate of clinical treatment in the experimental group was 95.00%,which was significantly higher than 65.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of mRS and NIHSS in the two groups decreased,and those in the experimental group were lower than the control group,and the differences were statistically significant(P<0.05).The incidences of upper gastrointestinal hemorrhage and intracranial hemorrhage in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion In the clinical treatment of acute cerebral infarction by rtPA intravenous thrombolysis,the curative effect of the time window<3.0 hours from onset to administration is definite and safe.