多模式CT指导下再灌注治疗在醒后卒中患者中的应用

Application of Multimodal CT Guided Reperfusion Therapy in Patients with Wake-Up Stroke

目的:探讨多模式CT指导下再灌注治疗在醒后卒中(WUS)患者中的应用效果。方法:回顾性分析2021年3月至2023年8月入住我院的80例WUS患者临床资料,根据治疗方案分为对照组(50例,非多模式CT指导下再灌注治疗)和观察组(30例,多模式CT指导下再灌注治疗)。对比2组临床疗效、凝血功能[凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、纤维蛋白原(FIB)]、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分及术后症状性颅内出血(sICH)发生率。结果:观察组治疗有效率高于对照组(P<0.05);观察组患者治疗后的PT、APTT均低于对照组,FIB高于对照组(P<0.05);观察组患者治疗后7 d、14 d的NIHSS评分均低于对照组(P<0.05);观察组出院后90 d的mRS评分低于对照组(P<0.05);2组患者术后sICH发生率比较无显著差异(P>0.05)。结论:在多模式CT指导下进行再灌注治疗,能改善WUS患者神经缺损及凝血功能,提高患者日常活动能力,其疗效显著,具备安全性。

Purpose:To explore the application of multimodal CT guided reperfusion therapy in patients with wake-up stroke(WUS).Methods:Clinical data of 80 patients with WUS admitted to our hospital from March 2021 to August 2023 were retrospectively analyzed,and the patients were divided into control group(50 cases,reperfusion therapy under non-multi-modal CT guidance)and observation group(30 cases,reperfusion therapy under multi-modal CT guidance)according to the treatment regimens.The clinical efficacy,coagulation function[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB)],National Institutes of Health stroke scale(NIHSS)scores,modified Rankin scale(mRS)scores,and incidence of postoperative symptomatic intracranial hemorrhage(sICH)between two groups were compared.Results:The effective rate of 7-day treatment in observation group was higher than that in control group(P<0.05).PT and APTT in observation group after treatment were shorter than those in control group,and FIB was higher than that in control group(P<0.05).The NIHSS scores in observation group at 7-day and 14-day after treatment were lower than those in control group(P<0.05).The mRS score of the observation group after 90 days of discharge was lower than that of the control group(P<0.05).There was no statistically significant difference in the incidence rate of postoperative sICH between the two groups(P>0.05).Conclusion:Reperfusion therapy guided by multimodal CT can be used to improve neurological deficits and coagulation function,and enhance daily activity ability in WUS patients.It has significant therapeutic effects and safety.