临床医学工程
臨床醫學工程
림상의학공정
Clinical Medical & Engineering
2015年
10期
1347-1348
,共2页
静脉溶栓%脑微出血%急性脑梗死%出血性转化
靜脈溶栓%腦微齣血%急性腦梗死%齣血性轉化
정맥용전%뇌미출혈%급성뇌경사%출혈성전화
Intravenous thrombolysis%Cerebral microbleeds%Acute cerebral infarction%Hemorrhagic transformation
目的：探讨静脉溶栓治疗急性脑梗死合并脑微出血的出血性转化的预后情况。方法收集2012年2月至2015年2月我院收治的86例合并脑微出血的急性脑梗死患者，随机分为研究组和对照组各43例。对照组采用安慰剂治疗，研究组采用静脉溶栓治疗，随访3个月。使用美国国立卫生院卒中量表(NIHSS)评价神经功能缺损情况，修正Rankin量表评价长期预后。综合比较两组患者出血性转化率、病死率、治疗3个月mRS评分及治疗前后NIHSS评分情况。结果研究组患者出血性转化率为20.9%，高于对照组的2.3%，差异具有统计学意义(P＜0.05)；研究组病死率与对照组比较差异无统计学意义(9.3%vs 7.0%， P＞0.05)。研究组治疗后24 h、14 d的NIHSS评分以及治疗3个月后的mRS评分均低于对照组，差异具有统计学意义(P＜0.05)。结论静脉溶栓治疗合并脑微出血的急性脑梗死会增加出血性转化风险，可有效改善神经功能缺损及远期预后，不增加总体病死率，值得临床推广使用。
目的：探討靜脈溶栓治療急性腦梗死閤併腦微齣血的齣血性轉化的預後情況。方法收集2012年2月至2015年2月我院收治的86例閤併腦微齣血的急性腦梗死患者，隨機分為研究組和對照組各43例。對照組採用安慰劑治療，研究組採用靜脈溶栓治療，隨訪3箇月。使用美國國立衛生院卒中量錶(NIHSS)評價神經功能缺損情況，脩正Rankin量錶評價長期預後。綜閤比較兩組患者齣血性轉化率、病死率、治療3箇月mRS評分及治療前後NIHSS評分情況。結果研究組患者齣血性轉化率為20.9%，高于對照組的2.3%，差異具有統計學意義(P＜0.05)；研究組病死率與對照組比較差異無統計學意義(9.3%vs 7.0%， P＞0.05)。研究組治療後24 h、14 d的NIHSS評分以及治療3箇月後的mRS評分均低于對照組，差異具有統計學意義(P＜0.05)。結論靜脈溶栓治療閤併腦微齣血的急性腦梗死會增加齣血性轉化風險，可有效改善神經功能缺損及遠期預後，不增加總體病死率，值得臨床推廣使用。
목적：탐토정맥용전치료급성뇌경사합병뇌미출혈적출혈성전화적예후정황。방법수집2012년2월지2015년2월아원수치적86례합병뇌미출혈적급성뇌경사환자，수궤분위연구조화대조조각43례。대조조채용안위제치료，연구조채용정맥용전치료，수방3개월。사용미국국립위생원졸중량표(NIHSS)평개신경공능결손정황，수정Rankin량표평개장기예후。종합비교량조환자출혈성전화솔、병사솔、치료3개월mRS평분급치료전후NIHSS평분정황。결과연구조환자출혈성전화솔위20.9%，고우대조조적2.3%，차이구유통계학의의(P＜0.05)；연구조병사솔여대조조비교차이무통계학의의(9.3%vs 7.0%， P＞0.05)。연구조치료후24 h、14 d적NIHSS평분이급치료3개월후적mRS평분균저우대조조，차이구유통계학의의(P＜0.05)。결론정맥용전치료합병뇌미출혈적급성뇌경사회증가출혈성전화풍험，가유효개선신경공능결손급원기예후，불증가총체병사솔，치득림상추엄사용。
Objective To study the prognosis of intravenous thrombolytic therapy on hemorrhagic transformation of acute cerebral infarction combined with cerebral microbleeds. Methods 86 cases of patients with acute cerebral infarction combined with cerebral microbleeds admitted to our hospital from February 2012 to February 2015 were selected and randomly divided into research group and control group, with 43 cases in each group. The control group was treated with placebo, the research group was treated with intravenous thrombolysis. All patients were followed up for 3 months. The nerve function defect was evaluated by US national institutes of health stroke scale (NIHSS), the long-term prognosis was evaluated by modified Rankin scale. The hemorrhagic transformation rate, mortality, mRS score 3 months after treatment, NIHSS score before and after the treatment were compared between two groups. Results The hemorrhagic transformation rate of research group was 20.9%, higher than 2.3%of control group, with statistical difference (P<0.05);the mortality of two groups had no statistical difference (9.3%vs 7.0%, P>0.05). The NIHSS score after 24 h, 14 d of the treatment and mRS score after 3 months of the treatment in research group were lower than those of control group, with statistically significant difference (P <0.05). Conclusions Intravenous thrombolysis in the treatment of acute cerebral infarction combined with cerebral microbleeds will increase the risk of hemorrhagic transformation, but can effectively improve the nerve function defect and long-term prognosis, without increasing total mortality, which is worthy of clinical promotion.
