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目的观察18例急性脑缺血性脑卒中患者行急诊重组组织型纤溶酶原激活剂(rTPA)静脉溶栓联合动脉溶栓或支架取栓治疗的疗效。方法对急性缺血性脑卒中患者18例实施rTPA静脉溶栓联合动脉溶栓或支架取栓治疗。急诊完善相关常规检查后立刻实施rTPA 0.9mg/kg静脉溶栓(总量不超过90mg;先静脉推注10%,其余90%泵注60min)。其后依据造影结果行动脉溶栓或Solitaire支架取栓治疗。采用美国国立卫生研究院卒中量表(NIHSS)评分评估疗效。结果18例中,除1例病情恶化外,其余17例患者症状均较治疗前好转或完全康复。溶栓前NIHSS评分为(15.9±3.2)分,治疗后即刻降低为(5.3±2.7)分(P<0.01),治疗后3d进一步降低为(3.1±1.5)分(P<0.05)。结论 rTPA静脉溶栓联合动脉溶栓或支架取栓是急性缺血性脑卒中治疗的有效方法。
Objective To observe the curative effect of emergency thrombolysis combined with thrombolysis in thrombolysis or stent thrombolysis in 18 patients with acute cerebral ischemic stroke underwent intravenous thrombolysis with recombinant tissue-type plasminogen activator (rTPA). Methods 18 patients with acute ischemic stroke were treated with rTPA intravenous thrombolysis combined with thrombolysis or stent thrombolysis. Emergency rpA 0.9mg / kg intravenous thrombolysis immediately after the completion of the relevant routine examination (the total does not exceed 90mg; the first intravenous injection of 10%, the remaining 90% pump 60min). Followed by angiography results of arterial thrombolysis or Solitaire stent thrombectomy. The NIH Stroke Scale (NIHSS) score was used to assess the efficacy. Results Among the 18 cases, the symptoms of the remaining 17 patients were all better than those before treatment except the one case was exacerbated or completely recovered. The NIHSS score before thrombolysis was (15.9 ± 3.2) minutes, immediately after treatment was (5.3 ± 2.7) minutes (P <0.01), and further decreased to (3.1 ± 1.5) minutes after treatment (P <0.05). Conclusion rTPA thrombolysis combined with thrombolysis or stent thrombolysis is an effective method for the treatment of acute ischemic stroke.