不同时间窗rt-PA静脉溶栓治疗急性脑梗死患者对其神经功能、血流动力学的影响

Effects of rt-PA Intravenous Thrombolysis in Different Time Windows on Neurological Function and Hemodynamics in Acute Cerebral Infarction

目的探讨急性脑梗死患者不同时间窗接受重组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)治疗,对促进其神经功能恢复、改善血流动力学的作用。方法方便选取2020年1月—2022年3月兴化市人民医院收治的急性脑梗死患者180例展开研究,随机分为对照组与观察组,各90例。对照组采取常规方式治疗,观察组在对照组基础上实施rt-PA静脉溶栓治疗,另外根据观察组患者发病时间划分观察Ⅰ组(发病0~3 h,45例)与观察Ⅱ组(发病3~4.5 h,45例),比较观察组和对照组治疗效果,检测对比观察Ⅰ、Ⅱ组患者不同时间窗静脉溶栓治疗前后血流动力学指标,评估对照组与观察Ⅰ、Ⅱ组患者治疗前后神经功能恢复情况。结果观察组治疗总有效率为95.56%,高于对照组,差异有统计学意义(χ^(2)=7.120,P<0.05)。治疗后,观察组Ⅰ、Ⅱ组NIHSS评分均低于对照组,Barthel评分均高于对照组,差异有统计学意义(P<0.05);其中观察Ⅰ组患者NIHSS评分低于观察Ⅱ组,Barthel评分高于观察Ⅱ组,差异有统计学意义(P<0.05)。结论急性脑梗死患者接受rt-PA静脉溶栓治疗具有确切疗效,同时发病0~3 h内的溶栓效果更佳,对调节患者血流动力指标,促进神经功能恢复具有显著效果。

Objective To investigate the effects of recombinant tissue plasminogen activator(rt-PA)therapy in different time windows on promoting neurological recovery and improving hemodynamics in patients with acute cerebral infarction.Methods A total of 180 patients with acute cerebral infarction admitted to Xinghua People's Hospital from January 2020 to March 2022 were conveniently selected for research.They were randomly divided into control group and observation group,with 90 cases in each group.The control group was treated conventionally,and the observation group was treated with rt-PA intravenous thrombolysis on the basis of the control group.In addition,the patients in the observation group were divided into observation group Ⅰ(0-3 h of onset,45 cases)and observation Ⅱ group(3-4.5 h of onset,45 cases)according to the onset time.Compared the treatment effects of the observation group and the control group,detected and compared the hemodynamic indicators of patients in groups Ⅰ and Ⅱ before and after intravenous thrombolysis treatment at different time windows,and evaluated the neurological function recovery of patients in the control group and observation groups Ⅰ and Ⅱ before and after treatment.Results The total effective rate in the observation group(95.56%)was higher than that in the control group,the difference was statistically significant(χ^(2)=7.120,P<0.05).After treatment,the NIHSS scores of patients in observation groups Ⅰ and Ⅱ were lower than those in the control group,and the Barthel scores were higher than those in the control group,the difference was statistically significant(P<0.05);among them,the NIHSS score of patients in observation group Ⅰ was lower than that in observation group Ⅱ,while the Barthel score was higher than that in observation group Ⅱ,the difference was statistically significant(P<0.05).Conclusion Patients with acute cerebral infarction who receive RT-PA intravenous thrombolysis therapy have a definite therapeutic effect,and the thrombolysis effect within 0-3 hours of onset is better.It has a significant effect on regulating patient hemodynamic indicators and promoting neurological function recovery,and it is advocated to use and promote.