超急性期脑梗死患者低剂量rt-PA静脉溶栓临床观察

目的探讨超急性期脑梗死TOAST分型对低剂量rt-PA静脉溶栓治疗效果的影响。方法选取2014-08—2016-05本院收治的超早期脑梗死(发病时间4.5h)患者75例为研究对象,按照TOAST分型分为CE组、SAA组和LAA组,所有患者均接受rt-PA静脉溶栓治疗,观察分析其临床效果及不良反应发生情况。结果 LAA组、CE组治疗后2h、7d其NIHSS评分与治疗前比较均明显改善,差异有统计学意义(P0.05);SAA组治疗前后其BI指数、NIHSS评分均无明显变化(P0.05);CE组不良反应发生率明显高于LAA组、SAA组,差异有统计学意义(P0.05)。结论对于不同TOAST分型的超早期急性脑梗死患者,采用rt-PA静脉溶栓治疗以CE、LAA患者疗效最为显著,而SAA患者多表现不佳,治疗过程中,对CE患者应加强病情观察和护理,以预防出血事件发生。

The clinical effect of intravenous thrombolytic therapy with low dose rt-PA in patients with different types of ultra-early cerebral infarction

Objective To explore the clinical effect of low dose rt-PA intravenous thrombolytic therapy in hyperacute cerebral infarction patients with TOAST classification.Methods 75 patients with cerebral infarction (onset time＜4.5 h) were treated in our hospital from August 2014 to May 2016.According to TOAST classification,they were divided into CE group,SAA group and LAA group.All patients underwent rt-PA thrombolytic therapy,and their clinical effects and adverse reactions were observed and analyzed.Results The NIHSS scores of treated LAA group and CE group at 2h and 7d were significantly higher than those before treatment (P＜0.05).There was no significant change of the BI index or NIHSS score before and after treatment in SAA group (P＞0.05).The incidence of adverse reactions in CE group was significantly higher than that in LAA group and SAA group (P＜0.05).Conclusion The treatment effect of rt-PA intravenous thrombolytic therapy was remarkable in CE and LAA patients,while in SAA patients was poor.For CE patients in the course of treatment,observation and care should be strengthened to prevent the occurrence of bleeding events