CAJ | 학술논문

目的：研究急性缺血性脑卒中患者不同时间窗阿替普酶（rt-PA）进行静脉溶栓和动脉溶栓治疗的临床效果和安全性的差异。方法：临床纳入120例我院2012年8月～2014年8月期间神经内科收治的急性缺血性脑卒中患者，将所有患者按随机抽样法分为两组,各60例。其中使用阿替普酶静脉溶栓治疗的作为静脉溶栓组，使用阿替普酶动脉溶栓治疗的作为动脉溶栓组，对比两组患者治疗结果以及组间安全性差异等。结果：静脉溶栓组治疗总有效率为93.33%，动脉溶栓组治疗总有效率为90.00%，P>0.05；两组患者治疗前、治疗后24h、14dNIHSS评分比较结果显示，两组患者评分具有一定程度下降，但两组间比较无显著差异，P>0.05；治疗后3个月两组患者预后情况、不良反应发生情况比较，两组再通率、预后良好率均较高，组间比较无差异（P>0.05）；两组ICH发生率、死亡率均较低，组间比较无差异（P>0.05）。结论：短期治疗与长期治疗均有良好预后效果及再通率，临床使用阿替普酶进行静脉溶栓和动脉溶栓治疗急性缺血性脑卒中效果良好，不良反应相似，临床推广价值高。
목적：연구급성결혈성뇌졸중환자불동시간창아체보매（rt-PA）진행정맥용전화동맥용전치료적림상효과화안전성적차이。방법：림상납입120례아원2012년8월～2014년8월기간신경내과수치적급성결혈성뇌졸중환자，장소유환자안수궤추양법분위량조,각60례。기중사용아체보매정맥용전치료적작위정맥용전조，사용아체보매동맥용전치료적작위동맥용전조，대비량조환자치료결과이급조간안전성차이등。결과：정맥용전조치료총유효솔위93.33%，동맥용전조치료총유효솔위90.00%，P>0.05；량조환자치료전、치료후24h、14dNIHSS평분비교결과현시，량조환자평분구유일정정도하강，단량조간비교무현저차이，P>0.05；치료후3개월량조환자예후정황、불량반응발생정황비교，량조재통솔、예후량호솔균교고，조간비교무차이（P>0.05）；량조ICH발생솔、사망솔균교저，조간비교무차이（P>0.05）。결론：단기치료여장기치료균유량호예후효과급재통솔，림상사용아체보매진행정맥용전화동맥용전치료급성결혈성뇌졸중효과량호，불량반응상사，림상추엄개치고。
Objective:To study the differences of clinical effect and safety of intravenous and arterial thrombolysis of rt-PA in patients with acute ischemic stroke at different time windows. Method:120 patients with acute ischemic stroke treated from August 2012 to August 2014 in our Neurology Department were selected and randomly divided into two groups, 60 cases each group. The intravenous group took the intravenous thrombolysis of rt-PA while the arterial group took the arterial thrombolysis of rt-PA. The treatment outcomes and safety of two groups were compared. Result:The total effective rate of intravenous and arterial group was 93.33% and 90.00%(P>0.05);before treatment and after 24h of treatment, 14dNIHSS of two groups was slightly reduced, but not significantly different among groups (P>0.05); after 3m of treatment, the prognosis and adverse reactions of two groups were compared. The recanalization rate and rate of favorable prognosis of two groups were higher, but not significantly different among groups (P>0.05); the incidence rate of ICH and death rate of two groups were lower, but not different among groups (P>0.05).Conclusion:The short-term and long-term therapy has a favorable prognosis and recanalization rate. The intravenous and arterial thrombolysis of rt-PA for acute ischemic stroke has a good effect and similar adverse reactions in clinical practices. It has a higher value of clinical promotion.