多模式MRI指导下急性缺血性脑卒中静脉溶栓治疗的临床观察

发布时间：2018-06-21 23:34

本文选题：多模式MRI + 急性缺血性脑卒中　；参考：《中华全科医学》2016年05期

【摘要】：目的了解多模式MRI检查对急性缺血性脑卒中静脉溶栓治疗的指导作用,保证静脉溶栓治疗的有效性和安全性。方法选取2013年8月—2015年8月收治的102例急性缺血性脑卒中患者。根据多模式MRI检查结果指导静脉溶栓治疗。不符合静脉溶栓患者作为对照组;入选的静脉溶栓患者作为治疗组,在对照组相同治疗方法的基础上,给予重组组织型纤溶酶原激活剂阿替普酶。比较2组治疗前和治疗后6 h、24 h、7 d的NIHSS评分,治疗7 d后评价疗效,并观察治疗期间的不良反应。结果根据PWI/DWI的不匹配性,治疗组55例符合静脉溶栓,对照组47例不符合静脉溶栓。2组的年龄、性别、吸烟史、卒中史、合并症等一般资料的差异均无统计学意义(P均0.05)。治疗组治疗后6 h、24 h、7 d的NIHSS评分为8.52±4.77、6.14±4.07、3.90±2.23,均显著小于对照组(t=1.775、2.875、2.024,P均0.05)。治疗组的总有效率为83.64%(46/55),显著高于对照组(χ~2=6.264,P0.05)。治疗期间,对照组的不良反应发生率为10.64%(5/47),治疗组的不良反应发生率为12.73%(7/55);2组不良反应发生率的差异无统计学意义(χ~2=0.107,P0.05)。结论多模式MRI对急性缺血性脑卒中静脉溶栓治疗具有指导作用,可提高静脉溶栓的疗效,具有较高的临床应用价值。
[Abstract]:Objective to investigate the guiding effect of multimode MRI on intravenous thrombolytic therapy in acute ischemic stroke and to ensure the efficacy and safety of intravenous thrombolytic therapy. Methods 102 patients with acute ischemic stroke from August 2013 to August 2015 were selected. According to the results of multi-mode MRI, intravenous thrombolytic therapy was guided. The patients with venous thrombolytic therapy were used as the control group and the patients with intravenous thrombolytic therapy were treated with recombinant tissue plasminogen activator Atiptase on the basis of the same treatment method in the control group. NIHSS scores were compared before and 6 hours after treatment in both groups, and the efficacy was evaluated after 7 days of treatment, and adverse reactions during treatment were observed. Results according to the mismatch of PWI / DWI, there were no significant differences in age, sex, smoking history, stroke history and complications between treatment group (55 cases) and control group (47 cases) (P 0.05). The NIHSS score of the treatment group was 8.52 卤4.7 卤4.07 卤6.14 卤4.07 卤3.90 卤2.23 at 6 hours and 24 hours after treatment, which was significantly lower than that in the control group (t = 1.775, 2.875n = 2.024, P = 0.05). The total effective rate of the treatment group was 83.64% (46 / 55), which was significantly higher than that of the control group (蠂 2 + 6.264%, P0.05). During the treatment period, the incidence of adverse reactions was 10.64% (5 / 47) in the control group and 12.73% (7 / 55) in the treatment group. There was no significant difference in the incidence of adverse reactions between the two groups (蠂 ~ (2 / 2) 0.107 (P0.05). Conclusion Multi-mode MRI has a guiding effect on intravenous thrombolytic therapy for acute ischemic stroke. It can improve the efficacy of intravenous thrombolytic therapy and has high clinical application value.
【作者单位】：桐乡市第一人民医院神经内科;
【分类号】：R743.3

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