摘要
目的探讨DWI-FLAIR不匹配的急性脑梗死患者的溶栓疗效。方法选择2019年6月-2020年12月浙江省永康市第一人民医院收治的116例急性脑梗死患者作为研究对象,所有患者磁共振成像表现为DWI-FLAIR序列不匹配。按照随机数字表法分为常规治疗组和溶栓组,每组58例。常规治疗组给予一般治疗(口服抗血小板聚集药物等治疗),溶栓组采用阿替普酶静脉溶栓治疗。比较两组神经功能(NIHSS评分)、日常生活活动能力(MBI)、预后(mRS评分)、不良反应及症状性颅内出血(sICH)发生率。结果出院前、治疗后1个月、治疗后3个月,溶栓组NIHSS评分、mRS评分低于常规治疗组(P<0.01),MBI评分高于常规治疗组(P<0.01);两组不良反应及sICH发生率比较差异均无统计学意义(P>0.05)。结论DWI-FLAIR不匹配的急性脑梗死患者行溶栓治疗可有效改善患者神经功能,提升日常生活能力,改善预后,且不良反应较轻,不增加sICH风险,安全有效。
Objective To investigate the effect of thrombolysis in patients with acute cerebral infarction with dwi-flair mismatch.Methods 116 patients with acute cerebral infarction treated in the first people's Hospital of Yongkang City,Zhejiang Province from June 2019 to December 2020 were prospectively selected as the research objects.All patients showed dwi-flair sequence mismatch on magnetic resonance imaging.They were randomly divided into routine treatment group and thrombolysis group,with 58 cases in each group.The routine treatment group was given general treatment(oral antiplatelet aggregation drugs,etc.),and the thrombolytic group was given intravenous thrombolytic therapy with alteplase.The neurological function(NIHSS score),activity of daily living(MBI),prognosis(MRS score),adverse reactions and the incidence of symptomatic intracranial hemorrhage(Sich)were compared between the two groups.Results Before discharge,1 month and 3 months after treatment,NIHSS score and Mrs score in thrombolytic group were lower than those in routine treatment group(P<0.01),and MBI score was higher than that in routine treatment group(P<0.01);There was no significant difference in the incidence of adverse reactions and Sich between the two groups(P>0.05).Conclusion Thrombolytic therapy in patients with dwi-flair mismatched acute cerebral infarction can effectively improve their neurological function,improve their ability of daily living and improve their prognosis.The adverse reactions are mild,do not increase the risk of Sich,and it is safe and effective.
作者
胡灵芝
黄金华
HU Lingzhi;HUANG Jinhua(Yongkang first people's Hospital,Yongkang 321300,China)
出处
《浙江实用医学》
2021年第4期282-285,289,共5页
Zhejiang Practical Medicine
基金
金华市科技计划项目(2020-4-163)。
