多模CT指导下静脉溶栓治疗在最后正常时间>4.5h醒后脑卒中患者中的应用效果

Effect of Multi-mode CT Guided Intravenous Thrombolytic Therapy in Stroke Patients after Waking Up at the Last Normal Time >4.5 h

目的:观察多模CT指导下应用静脉溶栓治疗在最后正常时间>4.5 h醒后脑卒中患者中的临床效果。方法:选取2019年9月-2020年12月在泰州市人民医院接受诊治的最后正常时间>4.5 h的醒后脑卒中患者40例。根据是否接受溶栓治疗将其分为对照组和观察组,每组20例。对照组采用非溶栓治疗,观察组采用多模CT指导下静脉溶栓治疗。比较两组美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、Barthel指数评分和48 h内出血情况。结果:观察组治疗后24 h、14 d的NIHSS评分均低于治疗前与对照组,对照组治疗后14 d的NIHSS评分低于治疗前,差异均有统计学意义(P<0.05)。治疗后90 d,两组远期生存质量较治疗前均改善,观察组mRS评分低于对照组,BI评分高于对照组,差异均有统计学意义(P<0.05)。两组治疗后48 h内出血情况比较,差异无统计学意义(P>0.05)。结论:多模CT指导下静脉溶栓治疗在最后正常时间>4.5 h醒后脑卒中患者中的应用,能改善神经功能,提高远期生存质量,且不增加出血风险,在最后正常时间>4.5 h醒后脑卒中患者的治疗中有重要价值,值得临床大力推广应用。

Objective:To observe the clinical effect of multi-mode CT guided intravenous thrombolytic therapy in stroke patients after waking up at the last normal time >4.5.Method:A total of 40 patients with stroke after waking up at the last normal time >4.5 h in Taizhou People’s Hospital from September 2019 to December 2020 were selected,and they were divided into the control group and the observation group according to whether they received thrombolytic therapy.The control group was treated with non-thrombolytic therapy after awakening,and the observation group was treated with multi-mode CT guided intravenous thrombolytic therapy.The NIHSS score,mRS score,Barthel index score and bleeding within 48 h of two groups were compared.Result:The NIHSS score of the observation group at 24 h and 14 d after treatment were lower than those before treatment and the control group,while the NIHSS score of the control group at 14 d after treatment was lower than that before treatment,the differences were statistically significant (P<0.05).At 90 d after treatment,the long-term quality of life in two groups were improved compared with those before treatment,mRS score in the observation group was lower than that in the control group,BI score was higher than that in the control group,the differences were statistically significant (P<0.05).There was no significant difference in bleeding within 48 h after treatment between two groups (P>0.05).Conclusion:The application of multi-mode CT guided intravenous thrombolytic therapy in patients with stroke after waking up at the last normal time >4.5 h can improve the neurological function and improve the long-term quality of life,without increasing the risk of bleeding.There is an important value in the treatment of patients with stroke after waking up at the last normal time >4.5 h,and it is worthy of clinical promotion and application.