高压氧结合阿替普酶静脉溶栓治疗急性缺血性脑卒中疗效观察

目的探讨高压氧条件下使用阿替普酶静脉溶栓治疗急性缺血性脑卒中（acute ischemic stroke, AIS）的临床疗效。 方法选取2016年7月至2017年7月泰安市中心医院收治的AIS患者38例，其中高压氧条件下静脉溶栓治疗18例（观察组），常规静脉溶栓治疗20例（对照组）。两组患者均在发病3 h内采用阿替普酶静脉溶栓治疗，记录两组患者入院时美国国立卫生研究院脑卒中量表（National Institute of Health stroke scale, NIHSS）评分，溶栓完成后2 h、24 h、7 d的NIHSS评分及发病90 d的NIHSS评分和改良Rankin量表（modified Rankin Scale, mRS）评分。计量资料的比较采用t检验，计数资料的比较采用χ²检验。 结果观察组患者入院时NIHSS评分显著高于对照组（t=4.216，P<0.01），溶栓治疗后2 h、24 h、7d及发病90 d的NIHSS评分均显著低于对照组（t=-3.957、-3.975、-2.184、-1.296，均P<0.01），发病90 d的mRS也显著低于对照组（t=-1.960，P<0.01）。 结论高压氧结合阿替普酶静脉溶栓治疗，在AIS发病早期阶段具有改善患者神经功能的作用。

Clinical efficiency of hyperbaric oxygen combined with alteplase on acute ischemic stroke

ObjectiveTo investigate the clinical efficacy of hyperbaric oxygen combined with alteplase in the treatment of acute ischemic stroke (AIS). Methods38 patients with AIS were recruited from July 2016 to July 2017 in Taian City Central Hospital, and they were divided into two groups: 18 patients were treated by hyperbaric oxygen combined with alteplase intravenous thrombolysis (observation group), 20 patients were only treated by Alteplase intravenous thrombolysis (control group). All patients were treated with alteplase intravenous thrombolysis within 3 hours after the onset of symptoms, and they were assessed before the treatment, 2 hours, 24 hours and 7 days after the treatment according to NIHSS and modified Rank in Scale (mRS). ResultsThe NIHSS score of the observation group was significantly higher than that of the control group before the treatment (t = 4.216, P<0.01). The NIHSS scores of the observation group at 2 h, 24 h, 7 d and 90 d after the treatment were significantly lower than those of the control group (t = -3.957, -3.975, -2.184, -1.296, P<0.01), and the mRS of 90 days after onset in the observation group was also significantly lower than that in the control group (t = -1.960, P<0.01). ConclusionHyperbaric oxygen combined with alteplase intravenous thrombolysis can improve the neurological function of patients in the early stage of AIS.