rt-PA静脉溶栓联合介入治疗对急性缺血性脑卒中患者MRS评分、Barthel指数、脑部血流动力学的影响.pdf
《rt-PA静脉溶栓联合介入治疗对急性缺血性脑卒中患者MRS评分、Barthel指数、脑部血流动力学的影响.pdf》由会员分享,可在线阅读,更多相关《rt-PA静脉溶栓联合介入治疗对急性缺血性脑卒中患者MRS评分、Barthel指数、脑部血流动力学的影响.pdf(4页珍藏版)》请在咨信网上搜索。
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5、t3信号通路对乳腺癌侵袭转移的作用机制J.武警医学,2 0 19,30(8):6 57-6 6 1.18 雷坤阳,谢文杰,孙庭,等MiR-744-5p通过靶向CCND1抑制肾透明细胞癌细胞的增殖、侵袭和迁移J南方医科大学学报,2022,42(5):712-717.(收稿日期:2 0 2 3-0 2-19D0I:10.3969/j.issn.1671-4695.2023.15.004rt-PA静脉溶栓联合介入治疗对急性缺血性脑卒中患者MRS 评分、Barthel指数、脑部血流动力学的影响蒋云秋刘健赵丹郑光宇丨何丰(宜宾市第一人民医院1急诊科;2 神经内科四川宜宾6 440 0 0)【摘要】目的探
6、究重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓联合介入治疗对急性缺血性脑卒中(AIS)患者的影响。方法前瞻性选取2 0 2 1年1月至2 0 2 2 年6 月宜宾市第一人民医院收治的AIS患者10 6 例作为研究对象,按随机数字表法将其分为对照组和观察组,各53例。对照组给予rt-PA进行静脉溶栓治疗,观察组在对照组的基础上进行介入治疗。比较两组的临床疗效;比较两组患者治疗前、治疗后2 4 h、治疗后3个月的美国国立卫生研究院卒中量表(NIHSS)评分,治疗前、治疗后3个月的改良Rankins量表(MRS)评分、Barthel指数、大脑中动脉(MCA)、大脑前动脉(A C A)、基底动脉(B
7、A)的平均血流速度;并记录治疗后3个月内发生的不良反应以及病死率。结果观察组总有效率为8 8.6 8%,高于对照组(7 3.58%),差异有统计学意义(P0.05)。治疗后2 4h、治疗后3个月,两组患者的NIHSS评分均较治疗前均降低,且观察组分别为(6.37 1.2 4)、(2.6 7 1.11分,均低于对照组(7.2 51.36)、(3.6 31.54)分,差异均有统计学意义(P0.05)。治疗后3个月,两组MRS评分较治疗前降低,Barthel 指数分数较治疗前升高,且观察组MRS评分为(1.9 8 0.2 1)分,低于对照组(2.56 0.34)分,Barthel指数分数为(8 7.
8、12 6.8 1)分,高于对照组(7 1.336.54)分,差异均有统计学意义(P0.05)。治疗后3个月,两组MCA、A C A、BA 的平均血流速度均高于治疗前,且观察组分别为(6 0.6 55.9 6)、(43.2 45.36)、(39.8 6 5.36)cm/s,均高于对照组(52.336.14)、(38.415.84)、(34.6 8 5.7 2)c m/s ,差异有统计学意义(P0.05)。观察组不良反应率为9.43%,低于对照组(2 4.53%),差异有统计学意义(P0.05)。结论rt-PA静脉溶栓联合介入治疗有利于AIS患者神经功能恢复,有利于患者生活质量以及日常生活能力的提
9、高,促进脑血流动力学的改善,并能减少不良反应的发生,值得临床推广应用。【关键词】急性缺血性脑卒中静脉溶栓改良Rankins量表脑部血流动力学Barthel指数Effects of rt-PA intravenous thrombolysis combined with interventional therapy on MRS score,Barthel index and cerebral hemody-namics in acute isohemic stroke patients.JIANG Yun-qiu,LIU Jian,ZHAO Dan,et al.Department of Em
10、ergency,Yibin First Peoples Hospi-tal,Yibin Sichuan 644000,China.【A b s t r a c t)O b j e c t i v e T o e x p l o r e t h e e f f e c t o f i n t r a v e n o u s t h r o m b o l y s i s w i t h r e c o m b i n a n t t i s s u e p l a s m i n o g e n a c t i v a t o r (r t -PA)c o m-bined with interv
11、entional therapy on patients with acute ischemic stroke(AIS).Methods A prospective study was conducted on 106 AIS patientstreated in Yibin First Peoples Hospital from January 2021 to June 2022.They were divided into the control group and the observation group accord-ing to random number table method
12、,with 53 patients in each group.Both groups underwent rt-PA intravenous thrombolysis,and the observationgroup underwent interventional therapy on this basis.The curative effect was compared between the two groups.The national institutes of healthstroke scale(NIHSS)scores before treatment,24 hours af
13、ter treatment,and 3 months after treatment were compared between the two groups.Themodified Rankins scale(MRS),Barthel index scores,mean blood flow velocity of the middle cerebral artery(MCA),anterior cerebral artery(ACA),and basilar artery(BA)before and 3 months after treatment were compared betwee
14、n the two groups;and the adverse reactions and mor-基金项目:四川省卫生厅课题(编号:17 PJ10206)文章编号:16 7 1-46 9 5(2 0 2 3)15-158 3-0 4:1584:tality rate that occurred within 3 months after treatment were recorded.Results The total effective rate of the observation group was 88.68%,higher than that of the control gro
15、up(73.58%),the difference was statistically significant(P 0.05).After 24 hours and 3 months of treat-ment,the NIHSS scores of two groups were lower than those before treatment,and those of the observation group were(6.37+1.24)and(2.671.11)scores,respectively,which were lower than those of the contro
16、l group(7.25 1.36)and(3.63 1.54)scores,the differenceswere statistically significant(P 0.05).After 3 months of treatment,the MRS scores of the two groups were lower than those before treatment,while the Barthel index scores were higher than those before treatment,MRS score of the observation group w
17、as(1.98+0.21)points,which waslower than that of the control group(2.56 0.34)points,and the Barthel index score was(87.12 6.81)points,which was higher than thatof the control group(71.33 6.54)points,the differences were statistically significant(P 0.05).At 3 months after treatment,the meanflow veloci
18、ty of MCA,ACA and BA were higher than those before treatment,and those of the mean flow velocity in the observation group were(60.65 5.96),(43.24 5.36),(39.86 5.36)cm/s,respectively,which were higher than those in the control group(52.33 6.14),(38.41 5.84),(34.68 5.72)cm/s,the differences were stati
19、stically significant(P 0.05).The adverse reaction rate in the observationgroup was 9.43%,which was lower than that in the control group(24.53%),the difference was statistically significant(P 0.05).Conclusion Rt-PA intravenous thrombolysiscombined with interventional therapy is conducive to the recov
20、ery of nerve function,improvement of quality of life,activities of daily living and cer-ebral hemodynamics in patients with AIS,and reduce the occurrence of adverse reactions.It was worth clinical promotion and application.Key words Acute ischemic stroke;Intravenous thrombolysis;Modified Rankin scal
21、e;Cerebral hemodynamics;Barthel index急性缺血性脑卒中(acute ischemic stroke,AIS)是最常见的卒中类型,是由于脑部供血障碍、局部脑组织供血动脉血流减少或突然停止导致 。AIS 具有高患病率、高致残率以及高致死率。目前,抗血小板、抗凝药物进行早期溶栓改善梗死部位的血流灌注是常用的治疗方法,但疗效不显著,且容易错过溶栓最佳时间,还会增加出血的风险2 。静脉溶栓是恢复AIS患者脑血流的重要措施之一,重组组织型纤溶酶原激活剂(recombi-nant tissue plasminogen activator,rt-PA)是静脉溶栓药物,对机体
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- rt PA 静脉 联合 介入 治疗 急性 缺血性 脑卒中 患者 MRS 评分 Barthel 指数 脑部 血流 动力学 影响
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