r-tPA动静脉联合溶栓治疗急性脑梗死疗效分析

目的评价重组组织型纤溶酶原激活物（r-tPA）动静脉联合溶栓治疗急性脑梗死的疗效及安全性。方法40例符合入选标准的急性脑梗死患者按入院先后顺序分为治疗组和对照组，治疗组先予以r-tPA静脉溶栓，然后在DSA下动脉溶栓，24h后常规予以抗血小板集聚、活血化瘀、营养脑细胞等治疗，对照组入院后即予以抗血小板集聚、扩张血管、脑神经保护剂等治疗。两组均采用美国国立卒中研究中心卒中量表（NIHSS），Barthel指数（BI）评价治疗前、治疗24h、14d、21d、90d患者的神经功能恢复状况。结果治疗组疗效明显优于对照组（P〈0．05）。治疗组并发症状性脑出血2例，死亡1例；对照组并发症状脑出血1例，无死亡病例。两组均无全身性出血发生。结论治疗组短期内能明显改善急性脑梗死患者的肢体功能状况，大大提高了患者的生活质量，促进了临床预后的改善。

The Clinical Analysis of Recombinant Tissue Plasminogen Activator (r-tPA) through Arteriovenous Thrombolysis to Cure Acute Cerebral Infarction

Objective To Evaluate the curative effect and safety of the recombinant tissue plasminogen activator（r-tPA）combined with intravenous and intra-arterial thrombolysis in treatment of patients with acute cerebral infarction. Methods Forty cases according with clinical diagnostic criteria for acute cerebral infarction were recruited in the hospital,which divided into the treatment group and control group,the treatment group was treated with intravenous thrombolysis,then arterial thrombolysis in DSA,there were given antiplatelet converging,promoting blood circulation to remove blood stasis,nutrition brain cells etc after 24 hours,while only the same drug in control group. By evaluating the national stroke research center stroke scale （NIHSS） scores and Barthel index （BI） pre and post treatment （24 hours, 14 days,21 days,90 days）, neurological functions were assessed. Results The curative effect of treatment group is obvious higher than that of control group （P〈0.05）,there were two cerebral hemorrhage in treatment group,and one died. The control group didn＇t have syndrome,two groups have no systemic hemorrhage. Conclusion The treatment group can obviously delelop the limb functional condition in short time, greatly improving the quality of life, and promoting the improvement of clinical outcomes.