中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2010年
4期
256-260
,共5页
孙威%丁则昱%张静波%隋欣宁%王玉萍%李雪媛%赵红军%李树昌%廖晓凌%王拥军
孫威%丁則昱%張靜波%隋訢寧%王玉萍%李雪媛%趙紅軍%李樹昌%廖曉凌%王擁軍
손위%정칙욱%장정파%수흔저%왕옥평%리설원%조홍군%리수창%료효릉%왕옹군
脑梗死%血栓溶解疗法%组织型纤溶酶原激活物%体层摄影术%X线计算机
腦梗死%血栓溶解療法%組織型纖溶酶原激活物%體層攝影術%X線計算機
뇌경사%혈전용해요법%조직형섬용매원격활물%체층섭영술%X선계산궤
Brain infarction%Thrombolytic therapy%Tissue plasminogen activator%Tomography,x-ray computed
目的 对发病3～9 h内的急性脑梗死患者,应用多模式CT指导下静脉rt-PA溶栓治疗,研究其疗效.方法 2007年8月至2009年5月于我院就诊,经多模式CT筛选出符合溶栓的患者27例.分为＞3～6 h组及7～9 h组,记录溶栓前、后的NIHSS、mRS及BI评分,症状性出血率和病死率.结果 27例样本中20例(74.1%)患者溶栓治疗有效,11例(40.7%)临床结局良好,5例(18.5%)血管完全再通,症状性出血1例(3.7%).其中＞3～6 h组有效率为92.3%(12/13,χ~2=4.34,P=0.037),血管冉通率38.5%(5/13,χ~2=6.608,P=0.010).结论 多模式CT指导下＞3～9 h溶栓是超过常规溶栓时间窗患者的一种可选择的治疗方法.
目的 對髮病3～9 h內的急性腦梗死患者,應用多模式CT指導下靜脈rt-PA溶栓治療,研究其療效.方法 2007年8月至2009年5月于我院就診,經多模式CT篩選齣符閤溶栓的患者27例.分為＞3～6 h組及7～9 h組,記錄溶栓前、後的NIHSS、mRS及BI評分,癥狀性齣血率和病死率.結果 27例樣本中20例(74.1%)患者溶栓治療有效,11例(40.7%)臨床結跼良好,5例(18.5%)血管完全再通,癥狀性齣血1例(3.7%).其中＞3～6 h組有效率為92.3%(12/13,χ~2=4.34,P=0.037),血管冉通率38.5%(5/13,χ~2=6.608,P=0.010).結論 多模式CT指導下＞3～9 h溶栓是超過常規溶栓時間窗患者的一種可選擇的治療方法.
목적 대발병3～9 h내적급성뇌경사환자,응용다모식CT지도하정맥rt-PA용전치료,연구기료효.방법 2007년8월지2009년5월우아원취진,경다모식CT사선출부합용전적환자27례.분위＞3～6 h조급7～9 h조,기록용전전、후적NIHSS、mRS급BI평분,증상성출혈솔화병사솔.결과 27례양본중20례(74.1%)환자용전치료유효,11례(40.7%)림상결국량호,5례(18.5%)혈관완전재통,증상성출혈1례(3.7%).기중＞3～6 h조유효솔위92.3%(12/13,χ~2=4.34,P=0.037),혈관염통솔38.5%(5/13,χ~2=6.608,P=0.010).결론 다모식CT지도하＞3～9 h용전시초과상규용전시간창환자적일충가선택적치료방법.
Objective To test the efficiency and safety of the application of multimode CT evaluation in intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in patients within >3 to 9 hours after stroke.Methods From August 2007 to May 2009,53 patients within > 3-9 h after stroke who visited the Third Hospital of Dalian were randomly recruited.Using multimode CT evaluation,27 patients eligible to receive intravenous thrombolytic therapy with rt-PA were found and treatment to them within >3-6 h or 7-9 h after onset of ischemic stroke were given.Their mRS,NHISS and BI were scaled and recorded before and after intravenous thrombolytic therapy.Death rate and symptomatic intracranial hemorrhage rate were calculated.Results After rt-PA treatment,20 of 27 (74.1%) patients had increased clinical activity by 4 points or more on the NIHSS.Favorable outcome rate of patients with mRS were 0 to 1 on 90 d was 40.1%.Five patients (18.5%) had recanalization in the occluded arteries after rt-PA treatment There was 1 patient (3.1%) having symptomatic intracranial hemorrhage (ICH) in our study.In the group given treatment within > 3-6 h of onset,the outcome was improved with the effective rate reaching 92.3 % (χ~2 =4.34,P = 0.037),however,the recanalization rate was 38.5% (χ~2 =6.608,P =0.010).Conclusion Multimode CT evaluation in the rt-PA therapy is an useful tool to select eligible patients beyond 3 hours after acute ischemic stroke to have intravenous thrombolytic therapy with rt-PA.
