發(fā)布時(shí)間：2019-03-13 21:44

【摘要】：目的探討CT灌注成像(CTP)對(duì)超時(shí)間窗急性缺血性卒中患者靜脈溶栓進(jìn)行指導(dǎo)的可行性。方法按照發(fā)病時(shí)間及CTP檢查是否存在缺血半暗帶(IP)將35例患者分為三組:4.5 h組、4.5 h且存在IP組及4.5 h無(wú)IP組。前二組均進(jìn)行靜脈溶栓,第三組采用常規(guī)治療,并于24 h、7 d、30 d及90 d分別進(jìn)行神經(jīng)功能評(píng)分。結(jié)果前二組治療后神經(jīng)功能明顯改善(P0.01),且兩組之間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);常規(guī)治療組24 h NIHSS評(píng)分無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),30 d改良Rankin評(píng)分無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),90 d有明顯差異(P0.01);常規(guī)治療組與溶栓組相比24 h、7 d、30 d神經(jīng)功能評(píng)分統(tǒng)計(jì)學(xué)差異不明顯(P0.05),90 d神經(jīng)功能評(píng)分前者明顯低于后者(P0.01)。結(jié)論使用CTP指導(dǎo)急性缺血性卒中超時(shí)間窗患者靜脈溶栓有重要意義。
[Abstract]:Objective to investigate the feasibility of CT perfusion imaging (CTP) in the guidance of intravenous thrombolysis in patients with acute ischemic stroke with super-time window. Methods 35 patients with ischemic penumbra (IP) were divided into three groups according to the onset time and CTP examination: 4.5h group, 4.5h group and IP group and 4.5h group without IP. The first two groups were treated with intravenous thrombolysis, and the third group were treated with routine therapy, and the neurological function scores were evaluated at 24 h, 7 d, 30 d and 90 d, respectively. Results the neurological function of the first two groups was significantly improved after treatment (P0.01), and there was no significant difference between the two groups (P0.05). There was no significant difference in 24-hour NIHSS score in the routine treatment group (P0.05), and there was no significant difference in the modified Rankin score on the 30th day (P0.05), and there was a significant difference on the 90th day (P0.01). Compared with thrombolysis group, there was no significant difference in neurological function scores at 24 hours, 7 days and 30 days in the routine treatment group (P0.05), while the neurological function scores in the former group were significantly lower than those in the latter group on the 90th day (P0.01). Conclusion it is important to use CTP to direct intravenous thrombolysis in patients with acute ischemic stroke with super-time window.
【作者單位】： 江蘇省張家港市中醫(yī)醫(yī)院放射科;江蘇省張家港市中醫(yī)醫(yī)院神經(jīng)內(nèi)科;
【基金】：江蘇省張家港市科技支撐計(jì)劃(社會(huì)發(fā)展)項(xiàng)目(編號(hào):ZKS1216)
【分類號(hào)】：R743.3;R816.1

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