急性脑梗死应用多模式CT指导下rt-PA静脉溶栓的疗效观察

Preliminary study of rt-PA intravenous thrombolysis in acute cerebral infarction guided by multimodal CT

目的 :探讨多模式CT指导下的急性脑梗死rt-PA静脉溶栓的临床疗效。方法 :将2015年2月~2016年2月间90例急性脑梗死患者根据治疗方法的不同分为观察组和对照组,观察组于治疗前及治疗后采用多模式CT检查,采用rt-PA静脉溶栓治疗,对照组采用奥扎格雷钠注射液+阿司匹林治疗。比较两组患者治疗后血管再通情况、神经功能改善情况及不良反应。结果 :观察组血管再通率51.1%(23/45),显著高于对照组的26.7%(12/45。两组治疗后TIMI分级均显著改善,且观察组改善情况明显优于对照组。治疗后24h、7d及30d,两组NIHSS评分呈明显下降趋势,且观察组显著优于对照组。观察组共5例(11.1%)患者出现症状性脑出血,与对照组(4.4%)无统计学意义。结论 :多模式CT指导下的急性脑梗死rt-PA静脉溶栓治疗能够明显改善患者血流灌注,促进神经功能恢复。

Objective To study the effect of rt-PA intravenous thrombolysis in acute cerebral infarction guided by multimo-dal CT.Methods From February 2015 to February 2016,90 patients with acute cerebral infarction were divided into observa-tion group and control group according to different treatment methods, Observation group before treatment and after treatment using multi-mode CT examination, Intravenous thrombolysis with rt-PA, The control group using Ozagrel Sodium Injection + aspirin. The recanalization, neurological improvement and adverse reactions were compared between the two groups.Results The recanalization rate of the observation group was 51.1% (23/45), Significantly higher than the control group 26.7% (12/45). Two groups after treatment TIMI classification were significantly improved, And the observation group improved significantly better than the control group. After treatment 24h,7d and 30d, the two groups NIHSS score showed a significant downward trend, And the observation group was significantly better than the control group. Symptomatic cerebral hemorrhage was observed in5 patients (11.1%) in the observation group, And the control group (4.4%) was not statistically significant.Conclusion In-travenous thrombolysis with rt-PA in patients with acute cerebral infarction guided by multimodal CT can significantly improve the blood perfusion, Promote the recovery of neurological function.