超早期静脉溶栓与动脉溶栓在急性脑梗死患者中的应用效果对比

Comparison of the Effects of Ultra Early Intravenous Thrombolysis and Arterial Thrombolysis in Patients with Acute Cerebral Infarction

目的探讨超早期静脉溶栓与动脉溶栓在急性脑梗死(ACI)患者中的应用效果。方法选择我院2021年4月—2023年5月收治的84例ACI患者为研究对象,按随机数字表法将其分为对照组和观察组,各42例。对照组采用超早期静脉溶栓治疗,观察组采用超早期动脉溶栓治疗。对比两组美国国家卫生研究院卒中量表(NIHSS)评分、纤维蛋白原(FIB)、凝血酶原时间(PT)及凝血酶时间(TT)及不良反应发生情况。结果治疗72 h后,观察组NIHSS评分(7.76±0.87)分低于对照组的(12.25±1.46)分,差异有统计学意义(P<0.05);观察组FIB水平(3.96±0.41)g/L高于对照组的(2.33±0.34)g/L,PT(12.33±1.96)s及TT(16.33±2.34)s均短于对照组的(14.55±2.68)s、(18.26±2.85)s,组间差异有统计学意义(P<0.05)。观察组不良反应发生率4.76%低于对照组的19.05%,差异有统计学意义(P<0.05)。结论相较于超早期静脉溶栓,超早期动脉溶栓更能够改善ACI患者神经功能与凝血功能,且不良反应发生率较低,值得临床推广应用。

Objective To explore the application effect of ultra early intravenous thrombolysis and arterial thrombolysis in patients with acute cerebral infarction(ACI).Methods A total of 84 ACI patients admitted to our hospital from April 2021 to May 2023 were selected as the research objects and randomly divided into a control group and an observation group,each with 42 cases,using a random number table method.The control group was treated with ultra early intravenous thrombolysis,while the observation group was treated with ultra early arterial thrombolysis.Compare the National Institutes of Health Stroke Scale(NIHSS)score,fibrinogen(FIB),prothrombin time(PT),and thrombin time(TT),and adverse reactions were compared between the two groups.Results After 72 hours of treatment,the NIHSS score of the observation group after treatment was(7.76±0.87)points,lower than(12.25±1.46)points in the control group,and the difference was statistically significant(P<0.05);the FIB level in the observation group was(3.96±0.41)g/L,which was higher than(2.33±0.34)g/L in the control group,the PT and TT were(12.33±1.96)s and(16.33±2.34)s,respectively,which were shorter than(14.55±2.68)s and(18.26±2.85)s in the control group,and the differences between the groups were statistically significant(P<0.05).The incidence of adverse bleeding events in the observation group was 4.76%,which was lower than 19.05%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared to ultra early intravenous thrombolysis,ultra early arterial thrombolysis can better improve neurological and coagulation function in ACI patients,and the incidence of adverse reactions is low,which is worthy of clinical application.