本文關(guān)鍵詞：腦梗死超急性期靜脈溶栓治療的效果　出處：《中華衛(wèi)生應(yīng)急電子雜志》2016年03期 　論文類型：期刊論文

  更多相關(guān)文章： 腦梗塞 超早期 靜脈溶栓 證候

【摘要】：目的探討靜脈溶栓療法應(yīng)用于急性腦梗死(ACI)患者中的臨床療效。方法隨機(jī)選擇2012年6月至2016年3月東莞市中醫(yī)院神經(jīng)內(nèi)科病房收治的ACI患者60例,其中男性37例,女性23例,平均年齡(68.2±8.5)歲。按照隨機(jī)數(shù)字表法分為對(duì)照組和觀察組。對(duì)照組(30例)給予常規(guī)內(nèi)科治療,觀察組(30例)則在對(duì)照組基礎(chǔ)上給予重組組織型纖溶酶原激活物(rt-PA)靜脈溶栓治療。并比較兩組的美國(guó)國(guó)立衛(wèi)生研究院卒中量表(NIHSS)評(píng)分以及實(shí)驗(yàn)室指標(biāo)以評(píng)價(jià)臨床效果。結(jié)果觀察組患者從治療后第1,3,5,7,14 d的NIHSS評(píng)分均顯著低于對(duì)照組,通過雙因素方差分析,兩組差異具有統(tǒng)計(jì)性(P0.05)。治療前后,觀察組(30例)27例有效,總有效率為90%,明顯高于對(duì)照組(30例)9例有效,有效率為30%,同時(shí)經(jīng)軼和檢驗(yàn)兩組具有統(tǒng)計(jì)學(xué)差異(χ~2=22.50,P0.05)。觀察組中,半身不遂及舌強(qiáng)語蹇減分值明顯高于對(duì)照組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),觀察組血管緊張素I為36.64±14.63 mmol/L,顯著高于對(duì)照組的25.71±16.99 mmol/L,而白介素-6為68.75±46.46 mmol/L,明顯地低于對(duì)照組的89.91±37.42 mmol/L(P0.05),其他理化指標(biāo)在兩組間差異無統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)軼和檢驗(yàn),觀察組在風(fēng)證、痰證和疲證方面的療效優(yōu)于對(duì)照組(P0.05),而其他四類證候差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論本研究結(jié)果表明靜脈溶栓療法能夠有效治療急性腦梗死,改善患者生存質(zhì)量,值得臨床推廣。
[Abstract]:Objective to investigate the clinical efficacy of intravenous thrombolytic therapy in patients with acute cerebral infarction (ACI). Methods a total of 60 patients with ACI were selected from June 2012 to March 2016 in the neurology ward of Dongguan Hospital of traditional Chinese medicine, including 37 males and 23 females, with an average age of (68.2 + 8.5) years. According to the random number table method, the control group and the observation group were divided into the control group and the observation group. The control group (30 cases) was given conventional medical treatment, while the observation group (30 cases) was given thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) on the basis of the control group. The two groups of the National Institutes of Health Stroke Scale (NIHSS) score and laboratory indicators were compared to evaluate the clinical effects. Results the NIHSS scores of the observation group were significantly lower than those of the control group after treatment. The difference between the two groups was statistically significant (P0.05) by two factor analysis of variance (1,3,5,7,14). The difference between the two groups was statistically significant (P0.05). Before and after treatment, the observation group (30 cases) and 27 cases were effective, the total effective rate was 90%, significantly higher than the control group (30 cases) and 9 cases were effective, effective rate was 30%, while the two Yi and test group with significant difference (~2=22.50, P0.05). In the observation group, hemiplegia and stiff tongue Jian minus score significantly higher than the control group, the difference was statistically significant (P0.05), the observation group of angiotensin I was 36.64 + 14.63 mmol/L, significantly higher than the control group of 25.71 + 16.99 mmol/L, and IL -6 68.75 + 46.46 mmol/L, significantly lower than the control group 89.91 + 37.42 mmol/L (P0.05), no statistically significant differences in other physicochemical indexes between the two groups (P0.05). By Yi and inspection, curative effect observation group in the wind syndrome and phlegm syndrome and fatigue syndrome is better than that of control group (P0.05), but no significant differences in the other four types of syndromes (P0.05). Conclusion the results of this study show that intravenous thrombolytic therapy can effectively treat acute cerebral infarction and improve the quality of life of the patients. It is worthy of clinical application.
【作者單位】： 東莞市中醫(yī)院內(nèi)三科;南方醫(yī)科大學(xué)珠江醫(yī)院急診科;
【分類號(hào)】：R743.3
【正文快照】： 腦梗死也稱為缺血性腦卒中(cerebral ischemicstroke,CIS),是臨床常見的腦血管疾病,具有較高的致死、致殘率[1]。腦梗死是指因腦組織局部血液供應(yīng)障礙,腦組織對(duì)缺血缺氧高度敏感,腦組織發(fā)生缺血、缺氧現(xiàn)象,腦動(dòng)脈急性閉塞導(dǎo)致缺血性腦梗死,肢體活動(dòng)障礙、身體感覺障礙等[2-4]

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