拓宽溶栓时间窗在急性缺血性脑卒中治疗中的应用价值

Application value of broadening thrombolytic time window in the treatment of acute ischemic stroke

目的探讨静脉溶栓治疗急性缺血性脑卒中(AIS)时采用不同时间窗的治疗效果。方法84例急性缺血性脑卒中患者,根据溶栓时间窗不同分为对照组和观察组,每组42例。两组患者均采用静脉溶栓治疗,观察组溶栓时间窗<4.5 h,对照组溶栓时间窗控制在4.5~12.0 h。比较两组患者治疗前后神经功能受损情况、生活能力、生活质量以及并发症发生情况。结果治疗1周、3个月后,观察组患者的美国国立卫生研究院卒中量表(NIHSS)评分分别为(6.38±3.17)、(3.07±1.42)分,均低于对照组的(8.67±4.02)、(7.49±1.61)分,差异具有统计学意义(P<0.05)。治疗后,观察组患者的改良Rankin量表评分(1.18±0.06)分低于对照组的(3.62±0.28)分,Barthel指数(BI)评分(80.08±3.25)分高于对照组的(72.57±2.64)分,差异具有统计学意义(P<0.05)。观察组患者的并发症发生率4.76%(2/42)与对照组的9.52%(4/42)比较,差异无统计学意义(P>0.05)。结论采用静脉溶栓治疗急性缺血性脑卒中患者,溶栓治疗时间窗控制在4.5 h内,能够较好地改善患者的神经功能,提升患者生活质量,并发症发生风险低。

Objective To discuss the therapeutic effect of different time windows in intravenous thrombolysis for acute ischemic stroke(AIS).Methods A total of 84 patients with acute ischemic stroke were divided into control group and observation group according to different thrombolytic time window,with 42 cases in each group.Both groups were treated with intravenous thrombolytic therapy.The thrombolytic time window in the observation group was<4.5 h,and that in the control group was 4.5-12.0 h.The neurological impairment,living ability and quality of life before and after treatment and complications were compared between the two groups.Results The National Institutes of Health Stroke Scale(NIHSS)score were(6.38±3.17)and(3.07±1.42)points in the observation group after 1 week and 3 months of treatment,which were lower than those of(8.67±4.02)and(7.49±1.61)points in the control group,and the differences were statistically significant(P<0.05).After treatment,the modified Rankin scale score of(1.18±0.06)points in the observation group was lower than that of(3.62±0.28)points in the control group,and the Barthel index(BI)score of(80.08±3.25)points was higher than that of(72.57±2.64)points in the control group.The differences were statistically significant(P<0.05).The incidence of complications in the observation group was 4.76%(2/42),and the difference was not statistically significant when compared with that of 9.52%(4/42)in the control group(P>0.05).Conclusion In the treatment of patients with acute ischemic stroke,controlling time window within 4.5 h in intravenous thrombolysis can better improve the neurological function of patients,improve the quality of life of patients,and the risk of complications is low.