輕型缺血性腦卒中靜脈溶栓療效觀察

趙瑞榮

【摘要】 目的 分析輕型缺血性腦卒中靜脈溶栓治療的療效及安全性。方法 100例輕型缺血性腦卒中患者為研究對象， 采用同期對照法將患者分為研究組和對照組， 各50例。研究組根據(jù)患者發(fā)病時間采用阿替普酶或尿激酶靜脈溶栓治療， 對照組采用阿司匹林治療。比較兩組患者治療前后的美國國立衛(wèi)生研究院卒中量表（NIHSS） 評分， 住院時間及治療后3個月的改良RANKIN量表（mRS） 評分， 治療后致殘、出血及再發(fā)性缺血性腦卒中發(fā)生情況。結(jié)果 治療前， 兩組患者的NIHSS評分對比， 差異無統(tǒng)計學(xué)意義（P>0.05）; 治療后， 兩組患者的NIHSS評分均較本組治療前降低， 且研究組NIHSS評分為（1.21±0.34）分， 低于對照組的（2.46±0.46）分， 差異均具有統(tǒng)計學(xué)意義 （P<0.05）。研究組患者住院時間為（4.25±0.55）d， 短于對照組的（5.12±0.52）d， 差異具有統(tǒng)計學(xué)意義 （P<0.05）;治療后3個月， 研究組患者mRS評分為（1.61±0.34）分， 低于對照組的（2.18±0.42）分， 差異具有統(tǒng)計學(xué)意義（P<0.05）。研究組殘疾率為6.0%， 低于對照組的20.0%， 差異具有統(tǒng)計學(xué)意義（P<0.05）;研究組出血率為0、再發(fā)性缺血性腦卒中發(fā)生率為4.0%， 對照組出血率為0、再發(fā)性缺血性腦卒中發(fā)生率為4.0%， 對比差異均無統(tǒng)計學(xué)意義（P>0.05）。結(jié)論 對輕型缺血性腦卒中患者積極采取靜脈溶栓治療， 有利于改善其神經(jīng)功能缺損情況， 利于患者預(yù)后， 適用于臨床。

【關(guān)鍵詞】 輕型缺血性腦卒中;靜脈溶栓;阿替普酶;尿激酶

DOI：10.14163/j.cnki.11-5547/r.2019.17.001

Observation on efficacy of mild ischemic stroke? ?ZHAO Rui-rong. Dongguan Kanghua Hospital， Dongguan 523000， China

【Abstract】 Objective? ?To analyze the efficacy and safety of intravenous thrombolytic therapy for mild ischemic stroke. Methods? ?A total of 100 mild ischemic stroke patients as study subjects were divided into research group and control group according to synchronized control method， with 50 cases in each group. The research group was treated by intravenous thrombolysis with ateplase or urokinase according to the time of onset， and the control group was treated with aspirin. Comparison were made on National Institutes of Health Stroke scale （NIHSS） score， hospitalization time， modified RANKIN scale （mRS） score at 3 months after treatment， occurrence of disability， bleeding and recurrent ischemic stroke after treatment between the two groups. Results? ?Before treatment， both groups had no statistically significant difference in NIHSS score （P>0.05）. After treatment， both groups had lower NIHSS score than that before treatment， and the research group had lower NIHSS score as （1.21±0.34） points than （2.46±0.46） points in the control group. Their difference was statistically significant （P<0.05）. The research group had shorter hospitalization time as （4.25±0.55） d than （5.12±0.52） d in the control group， and the difference was statistically significant （P<0.05）. After 3 months of treatment， the research group had lower mRS score as （1.61±0.34） points than （2.18±0.42） points in the control group， and the difference was statistically significant （P<0.05）. The research group had lower disability rate as 6.0% than 20.0% in the control group， and the difference was statistically significant （P<0.05）. The research group had bleeding rate as 0， incidence of recurrent ischemic stroke as 4.0%， which were 0 and 4.0% in the control group. Their difference was not statistically significant （P>0.05）. Conclusion? ?Intravenous thrombolytic therapy for mild ischemic stroke patients is beneficial to improve the neurological deficits and prognosis. It is suitable for clinical application.