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目的研究脑卒中患者不同时间段急诊溶栓治疗的近期远期疗效。方法在我院2014年3月~2016年12月收治的脑卒中患者中选出120例为研究对象,回顾性分析全部患者的临床资料,患者均采用重组组织型纤溶酶原激活剂(rt-PA)进行急诊溶栓治疗,根据患者急诊溶栓治疗的时间进行分组,观察组患者的急诊溶栓时间为发病后的0~4.5h;对照组患者急诊溶栓时间为发病后的4.5~6h;对比两组患者近期远期疗效。结果观察组患者溶栓24h、7d的NIHSS评分比对照组患者低,P<0.05;观察组患者死亡率3.33%与对照组的6.67%对比差异无统计学意义,P>0.05;观察组存活患者的并发症发生率6.90%与对照组的8.93%差异无统计学意义,P>0.05;两组存活患者在治疗6个月、12个月、18个月时的Fugl-Meyer评分、ADL评分差异不大,P>0.05。结论脑卒中患者急诊应用rt-PA溶栓治疗中可以适当延迟时间窗到发病后6h,对于4.5~6h的患者,选择其中神经功能缺损程度较低的患者接受静脉溶栓治疗,挽救患者生命。
Objective To study the short-term long-term efficacy of emergency thrombolytic therapy in patients with stroke at different time periods. Methods A total of 120 stroke patients were selected from March 2014 to December 2016 in our hospital. The clinical data of all patients were retrospectively analyzed. All patients were treated with recombinant tissue plasminogen activator (rt -PA) for emergency thrombolytic therapy according to the time of emergency thrombolytic therapy in patients in the observation group, the emergency thrombolytic time in the observation group was 0-4.5h after the onset of disease; the control group patients with emergency thrombolysis time was 4.5 ~ 6h; compare the two groups of patients with long-term long-term efficacy. Results In the observation group, the NIHSS scores at 24 and 7 days after thrombolysis were lower than those in the control group (P <0.05). There was no significant difference between the observation group and the control group (3.33% vs. 6.67%, P> 0.05) Complication rate 6.90% and 8.93% in the control group, P> 0.05; Fugl-Meyer score, ADL score difference of the surviving patients in 6 months, 12 months and 18 months Not big, P> 0.05. Conclusions In acute stroke patients, rt-PA thrombolytic therapy can be properly delayed time window to 6h after onset, for 4.5 ~ 6h patients, select a lower degree of neurological deficit in patients receiving intravenous thrombolysis to save the lives of patients.