急性轻型缺血性脑卒中rt-PA静脉溶栓治疗的疗效分析

Efficacy of intravenous thrombolysis with rt-PA in people with Acute Mild Ischemic Stroke

目的评估基于二维图像模型的模拟增强现实(augmentedreality AR)技术在脑出血引流术前路径规划中的应用价值。方法回顾性分析我院自2020年2月至2022年2月我院脑出血(出血量20~40 ml)引流手术治疗患者140例。其中研究组72例,应用基于二维图像模型的模拟AR技术辅助路径规划血肿引流手术。对照组68例,应用虚拟现实(virtual reality,VR,3D-slicer软件)联合增强现实(Sina软件)技术辅助路径规划血肿引流术。对比两组患者路径规划时间、血肿清除率、带引流管时间、治疗有效率、预后良好率的差异,评价基于二维图像模型的模拟AR技术辅助路径规划在脑出血引流术中的应用价值。结果研究组路径规划时间和对照组比较,差异有统计学意义(P<0.05)。两组血肿清除率、带引流管时间、治疗有效率、预后良好率等比较差异无统计学意义(P>0.05)。结论基于二维图像模型的模拟AR技术辅助脑出血引流术前路径规划,方便快捷,效果良好。

Objective To observe the effectiveness and safety of intravenous thrombolysis with rt-PA in patients of acute mild ischemic stroke.Methods Retrospective analyze a total of 107 acute ischemic stroke patients with baseline NIHSS<3 were enrolled in the study who hospitalized in Shanghai Jiading District Central Hospital from January 2021 to December 2021.Acco rding to whether performing intravenous thrombolysis or not,107 patients were divided into intravenous thrombolysis group(n=49)and non-venous thrombolysis group(n=58).The baseline and clinical data were recorded for both groups and their differences were compared.The scores and the rates of reduction of NIHSS in 24 h,7d and 14 d after treatment of the two groups were analyzed,also the scores of 7dmRs and 9odmRS.The incidence of extracranial/intracranial hemorrhage,the rate of death was also compared between the two groups.Results There were no sigwere lower in intravenous thrombolysis group,p was 0.020 and 0.008 respectively.The rate of reduction of NIHSS in 24 h,7d and 14 d were higher in intravenous thrombolysis group,all the three p were O.000.The scores of 7 d and 9odmRS were lower in intravenous thrombolysis group,but only 7dmRS score between the two groups was statistically significant,P=0.014,while 90dmRS score between the two groups was not statistically significant,P=0.153.Both at 7 d and 90 d,the proportions of good prognosis(mRS score 0-2)inintravenous thrombolysis group were higher,but there was no differencebetween the two groups,neither at 7 d nor at 90 d after treatment,p were 0.109 and 0.358 respectively.The incidences of extracranial hemorrhage and intracranial hemorrhagewere higher in intravenous thrombolysis group,p was 0.000 and 0.018 respectively.But no symptomatic intracranial hemorrhageand death occurred in both groups.Conclusion Thrombolysis with rt-PA inmildacuteischemicstroke(NIHSS<3)can improve early neurological deficits,increase the incidence of mild extracranial/intracranial hemorrhage,but with no serious adverse outcome.