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目的:探讨rt-PA溶栓治疗早期脑梗死的临床疗效。方法:选择自2013年3月到2014年4月入院的72例病人,随机分成2组,实验组36例溶栓治疗,对照组36例传统治疗。实验组治疗方法为阿替普酶5 mg+生理盐水10 m L静脉缓慢推注,余下0.7mg/Kg+0.9%氯化钠注射100 m L 60 min滴完。对研究对象进行治疗90天,行临床神经功能评分和Barthel指数测定,卒中复发率比较。结果:治疗90天,总有效率:实验组91.67%,对照组72.22%;ESS神经功能评分:实验组89.13±4.58,对照组67.24±6.37;Barthel指数:实验组86.53±4.29,对照组50.45±6.69;一年后卒中复发率:实验组19.4%,对照组36.1%;实验组与对照组相比有显著性差异(P<0.05);实验组出现2例脑出血;经治疗90天病死率:实验组:2.78%,对照组2.78%,二组无差异(P>0.05)。结论:重组型组织型纤溶酶原激活剂(rt-PA)在脑梗死早期治疗中起到重要的治疗效果,可改善病人的致残率,加快神经功能缺损恢复,值得临床推广。
Objective: To investigate the clinical efficacy of rt-PA thrombolytic therapy for early cerebral infarction. Methods: Seventy-two patients admitted to our hospital from March 2013 to April 2014 were randomly divided into two groups: 36 in the experimental group and 36 in the control group. The experimental group was treated with slow intravenous injection of alteplase 5 mg + saline 10 m L and the remaining 0.7 mg / kg + 0.9% sodium chloride injection 100 m L 60 min. The subjects were treated for 90 days, the clinical neurological score and Barthel index determination, the recurrence rate of stroke. Results: After 90 days of treatment, the total effective rate was 91.67% in the experimental group and 72.22% in the control group; ESS neurological function score was 89.13 ± 4.58 in the experimental group and 67.24 ± 6.37 in the control group; Barthel index was 86.53 ± 4.29 in the experimental group and 50.45 ± in the control group 6.69; the incidence of stroke after one year was 19.4% in the experimental group and 36.1% in the control group; there was significant difference between the experimental group and the control group (P <0.05); 2 cases of intracerebral hemorrhage occurred in the experimental group; : Experimental group: 2.78%, control group 2.78%, no difference between the two groups (P> 0.05). Conclusion: Recombinant tissue plasminogen activator (rt-PA) plays an important therapeutic role in the early stage of cerebral infarction. It can improve the morbidity of patients and accelerate the recovery of neurological deficits, which is worthy of clinical promotion.