大连医科大学学报
大連醫科大學學報
대련의과대학학보
JOURNAL OF DALIAN MEDICAL UNIVERSITY
2015年
1期
64-68
,共5页
急性%基底动脉闭塞%早期%静脉溶栓%疗效%预后
急性%基底動脈閉塞%早期%靜脈溶栓%療效%預後
급성%기저동맥폐새%조기%정맥용전%료효%예후
acute%basilar artery occlusion%early stage%intravenous thrombolysis%therapeutic effect%prognosis
目的：探讨早期静脉溶栓治疗急性基底动脉闭塞（ BAO）的疗效及预后。方法回顾性分析2012年1月—2014年2月期间住院部收治的52例行静脉溶栓治疗急性基底动脉闭塞患者的临床资料，分析溶栓效果、临床治疗效果、预后情况，同时探析治疗前神经功能障碍严重程度和溶栓时间窗对预后的影响。结果静脉溶栓治疗后完全再通率为63．46％，溶栓后NIHSS评分（12．55±3．68）分，明显低于治疗前（20．58±2．64）分（t＝12．7854， P＝0．0000）；治愈率为67．31％，6例（11．54％）溶栓后出现脑出血、消化道出血等并发症，无一例死亡；静脉溶栓时间≤180 min者预后良好率82．61％，明显高于静脉溶栓时间＞180 min者的预后良好率（44．83％）（χ2＝7．7357， P＝0．0054）；NIHSS评分≤20分者预后良好率为90．91％，明显高于NIHSS评分＞20分者预后良好率40．00％（χ2＝13．8982，P＝0．0002）；溶栓后90 dBI指数评分优良率为84．62％。结论静脉溶栓血管再通率较高，能显著改善患者的神经功能，临床治疗效果满意、并发症发生率低，预后良好且显著改善患者的生活质量，可作为临床治疗急性基底动脉闭塞的首选方案。
目的：探討早期靜脈溶栓治療急性基底動脈閉塞（ BAO）的療效及預後。方法迴顧性分析2012年1月—2014年2月期間住院部收治的52例行靜脈溶栓治療急性基底動脈閉塞患者的臨床資料，分析溶栓效果、臨床治療效果、預後情況，同時探析治療前神經功能障礙嚴重程度和溶栓時間窗對預後的影響。結果靜脈溶栓治療後完全再通率為63．46％，溶栓後NIHSS評分（12．55±3．68）分，明顯低于治療前（20．58±2．64）分（t＝12．7854， P＝0．0000）；治愈率為67．31％，6例（11．54％）溶栓後齣現腦齣血、消化道齣血等併髮癥，無一例死亡；靜脈溶栓時間≤180 min者預後良好率82．61％，明顯高于靜脈溶栓時間＞180 min者的預後良好率（44．83％）（χ2＝7．7357， P＝0．0054）；NIHSS評分≤20分者預後良好率為90．91％，明顯高于NIHSS評分＞20分者預後良好率40．00％（χ2＝13．8982，P＝0．0002）；溶栓後90 dBI指數評分優良率為84．62％。結論靜脈溶栓血管再通率較高，能顯著改善患者的神經功能，臨床治療效果滿意、併髮癥髮生率低，預後良好且顯著改善患者的生活質量，可作為臨床治療急性基底動脈閉塞的首選方案。
목적：탐토조기정맥용전치료급성기저동맥폐새（ BAO）적료효급예후。방법회고성분석2012년1월—2014년2월기간주원부수치적52례행정맥용전치료급성기저동맥폐새환자적림상자료，분석용전효과、림상치료효과、예후정황，동시탐석치료전신경공능장애엄중정도화용전시간창대예후적영향。결과정맥용전치료후완전재통솔위63．46％，용전후NIHSS평분（12．55±3．68）분，명현저우치료전（20．58±2．64）분（t＝12．7854， P＝0．0000）；치유솔위67．31％，6례（11．54％）용전후출현뇌출혈、소화도출혈등병발증，무일례사망；정맥용전시간≤180 min자예후량호솔82．61％，명현고우정맥용전시간＞180 min자적예후량호솔（44．83％）（χ2＝7．7357， P＝0．0054）；NIHSS평분≤20분자예후량호솔위90．91％，명현고우NIHSS평분＞20분자예후량호솔40．00％（χ2＝13．8982，P＝0．0002）；용전후90 dBI지수평분우량솔위84．62％。결론정맥용전혈관재통솔교고，능현저개선환자적신경공능，림상치료효과만의、병발증발생솔저，예후량호차현저개선환자적생활질량，가작위림상치료급성기저동맥폐새적수선방안。
Objective To analyze efficacy and prognosis of early Intravenous thrombolysis interventional treatment of acute basilar artery occlusion ( BAO) and to provide reference for future clinical treatment of BAO thrombolytic scheme selection, improve the prognosis and quality of life.Methods A retrospective analysis of 52 patients, who received routine arterial thrombolytic therapy, was performed in our hospital from 2012 January to February 2014.Clinical data of acute occlusion of the basilar artery thrombolysis effect, clinical treatment, prognosis, and treatment effect of anterior neural dysfunction se-verity and the prognosis of thrombolysis time window were analyzed.Results Artery recanalization rate after thrombolytic therapy was 63.46%.NIHSS score after thrombolysis ( 12.55 ±3.68 ) points was lower than that before treatment (20.58 ±2.64)points (t=12.7854, P=0.0000).The cure rate was 67.31%.6 cases (11.54%) had complications after thrombolysis including cerebral hemorrhage and gastrointestinal hemorrhage.There were no death cases.Intravenous thrombolysis time less than 180 min good prognosis rate of 82.61% was significantly higher than intravenous thrombolysis time>180 min good prognosis of 44.83% (χ2 =7.7357, P=0.0054).NIHSS score less than 20 points good prognosis rate of 90.91%was significantly higher than NIHSS score >20 points good prognosis of 40.00% (χ2 =13.8982, P=0.0002);90 d after thrombolysis BI index score the excellent and good rate was 84.62%.Conclusion Intra arterial throm-bolytic recanalization rate is higher and can significantly improve the neurological function of patients with satisfactory cura-tive effect and low incidence of complications.The prognosis is good and improving the quality of life of patients is signifi-cant.It can be used as the preferred scheme of clinical treatment of acute basilar artery occlusion.
