急诊溶栓干预对脑卒中不同阶段的治疗效果研究

目的:考察急诊溶栓干预对脑卒中不同阶段的治疗效果。方法:选择2009年3月—2012年2月急诊科收治的脑卒中患者96例为研究对象,按起病至接受溶栓治疗的时间将患者分为3组,<6h组(32例),6～10h组(33例)和11～24h组(31例),选择同期健康体检者28例作为对照组。结果:治疗前,3组脑卒中患者的神经功能缺损评分与对照组比较显著降低(P<0.05);<6.0h组和6～10h组及6～10h组和10～24h组的神经功能缺损评分相当(P>0.05);与<6.0h组比,10～24h组的神经功能缺损评分较低(P<0.05)。经治疗后,各个脑卒中组的评分显著提高(P<0.05)。治疗后2h,4h,与<6.0h组比,10～24h组的神经功能缺损评分较低(P<0.05);治疗24h后,3个组别之间比较差异无统计学意义(P>0.05)。治疗前,3个脑卒中组与对照组的凝血酶原时间(PT)、活化部分凝血时间(APTT)、纤维蛋白原(Fib)和血浆凝血酶时间(TT)比较差异有统计学意义(P<0.05)。与治疗前比,治疗后脑卒中3个组的各个凝血指标显著改善(P<0.05);治疗2h,与<6.0h组比,6～10h组PT和TT改善相当(P>0.05),10～24h组各指标改善不明显(P<0.05);治疗4h,与<6.0h组比,6～10h组APTT和TT改善相当(P>0.05),10～24h组各指标改善不明显(P<0.05)。治疗24h,3个脑卒中组间的凝血指标比较,差异无统计学意义(P>0.05)。结论:脑卒中晚期溶栓治疗与早期均有疗效,而早期溶栓疗效更显著。

Thrombolytic treatment on cerebral apoplexy at different stages in emergency

Objective:To investigate the effects of thrombolytic intervention on cerebral apoplexy at different stage.Methods:Ninety-six cases with cerebral apoplexy from March 2009 to February 2012 admitted in emergency department of our hospital were enrolled in our study.Results:Before treatment,compared with control,the neurological deficit scores of three cerebral apoplexy groups were significantly lower(P<0.05).The neurological deficit scores of <6.0 h group compared to 6~10 h group and 6~10 h group compared to 10~24 h group had no significant differences(P>0.05).Compared with <6.0 h group,scores in 10~24 h group were lower(P<0.05).After treatment,scores of each cerebral apoplexy group were significantly increased(P<0.05).Compared with <6.0 h group,scores in 10~24 h group were lower(P<0.05) in 2,4 h after treatment,and had no significant difference after 24 h of treatment(P>0.05).Compared with control,the prothrombin time(PT) and activated partial thromboplastin time(APTT),fibrinogen(Fib) and(thrombin time)TT were significantly different in 3 cerebral apoplexy groups(P<0.05).After treatment,coagulation indicators in 3 patient groups have improved significantly(P<0.05).After 2 hours treatment,compared with <6.0 h group,PT and TT in 6~10 h group were improved comparatively(P>0.05),PT,APTT,Fib and TT did not improve significantly in 10~24 h group(P<0.05).After 4 hours′ treatment,compared with <6.0 h group,APTT and TT in 6~10 h group were improved comparatively(P>0.05),PT,APTT,Fib and TT did not improve significantly in 10~24 h group(P<0.05).After 24 h treatment,PT,APTT,Fib and TT in 3 patient groups had no significant difference(P>0.05).Conclusion:The early,late thmmbolytic therapy for cerebral apoplexy is effective.But the effect of early cerebral apoplexy will be more pronounced.