阿替普酶静脉溶栓对重症脑梗死患者的临床效果及其对神经、凝血功能的改善效果分析

Clinical Effects of Intravenous Thrombolysis with Alteplase on Patients with Severe Cerebral Infarction,Improvement of Neurological and Coagulation Function

目的探讨阿替普酶静脉溶栓对重症脑梗死患者的临床效果及其对神经、凝血功能的改善效果。方法选择2020年4月—2022年4月期间临沂市中医医院收治的重症脑梗死患者80例为研究对象,随机分为两组,各40例。常规干预组采取常规治疗方案,阿替普酶组在此基础上给予阿替普酶静脉溶栓治疗。比较两组的临床疗效,治疗前后的神经功能、凝血功能指标变化,不良反应发生情况。结果阿替普酶组治疗总有效率(95.00%)显著高于常规干预组(75.00%),差异有统计学意义(χ^(2)=6.274,P<0.05)。治疗后12 h、1周及2周,阿替普酶组NIHSS评分均低于常规干预组,差异有统计学意义(P<0.05)。治疗后,阿替普酶组FIB、D-D水平低于常规干预组,PT、APTT优于常规组,差异有统计学意义(P<0.05)。阿替普酶组不良反应发生率(12.50%)与常规干预组(10.00%)比较,差异无统计学意义(P>0.05)。结论对重症脑梗死患者实施阿替普酶静脉溶栓治疗可缓解患者神经功能缺损症状,改善神经功能,减轻病残程度,改善凝血功能,获得良好的治疗效果,且安全性良好。

Objective To investigate the clinical effect of alteplase intravenous thrombolysis on patients with severe cerebral infarction and its improvement effect on nerve and coagulation function.Methods 80 patients with severe cerebral infarction admitted to Linyi Hospital of Traditional Chinese Medicine from April 2020 to April 2022 were selected as the research objects and randomly divided into two groups with 40 cases each.The conventional intervention group was treated with conventional therapy,and the alteplase group was given intravenous thrombolytic therapy with alteplase.The clinical efficacy,the changes of nerve function and coagulation function indexes before and after treatment,and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate(95.00%)in the alteplase group was significantly higher than that in the conventional intervention group(75.00%),the difference was statistically significant(χ^(2)=6.274,P<0.05).At 12 h,1 week and 2 weeks after treatment,NIHSS score of alteplase group was lower than that of conventional intervention group,the difference was statistically significant(P<0.05).After treatment,FIB and D-D levels in alteplase group were lower than those in conventional group,while PT and APTT were better than those in conventional intervention group,the difference was statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between alteplase group(12.50%)and conventional intervention group(10.00%)(P>0.05).Conclusion Alteplase intravenous thrombolysis for patients with severe cerebral infarction can alleviate neurological deficit symptoms,improve neurological function,reduce disability,improve coagulation function,and obtain good therapeutic effect and good safety.