摘要
目的:探讨床旁经颅多普勒超声(TCD)在急性脑梗死桥接治疗中的指导价值。方法:选择2019年5月-2022年1月景德镇市第一人民医院神经内科收治的80例急性脑梗死患者,按照随机数字表法将其分为两组,各40例。两组均行桥接治疗,对照组治疗过程中参考《中国急性缺血性脑卒中诊治指南》方案治疗,观察组加用床旁TCD指导桥接治疗。比较两组国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、Gonner评价血管再通成功率、并发症发生率及病死率。结果:观察组治疗后72 h的NIHSS评分与治疗后60 d的mRS评分均低于对照组(P<0.05)。观察组治疗72 h血管再通率为80.00%,高于对照组57.50%(P<0.05)。观察组并发症发生率为5.00%,低于对照组的20.00%(P<0.05)。观察组治疗后6个月病死率为10.00%,低于对照组的27.50%(P<0.05)。结论:桥接治疗用于急性脑梗死患者中,能获得良好的治疗效果,且患者治疗过程中配合床旁TCD指导,能减轻患者神经缺损,促进患者功能恢复,有助于提高血管再通成功率,降低并发症发生率及病死率。
Objective:To explore the guiding value of bedside transcranial Doppler(TCD)ultrasound in the bridging treatment of acute cerebral infarction.Method:A total of 80 patients with acute cerebral infarction who were admitted to the Department of Neurology of the Jingdezhen No.1 People's Hospital from May 2019 to January 2022 were selected,and they were randomly divided into two groups according to random number table,with 40 cases in each group.Both groups were treated with bridging treatment.The control group was treated with reference to the Guidelines for Diagnosis and Treatment of Acute Ischemic Stroke in China during the treatment process,the observation group was additionally treated with bedside TCD to guide bridging treatment.The national institutes of health stroke scale(NIHSS)scores,modified Rankin scale(mRS)scores,and Gonner evaluated the success rate of revascularization,complication rate and mortality were compared between the two groups.Result:NIHSS score at 72 h after treatment and mRS score at 60 d after treatment in observation group were lower than those in control group(P<0.05).The vascular recirculation rate was 80.00%in the observation group after 72 h of treatment,which was higher than 57.50%in the control group(P<0.05).The complication rate in observation group was 5.00%,which was lower than 20.00%in control group(P<0.05).The fatality rate in the observation group was 10.00%after 6 months,which was lower than 27.50%in the control group(P<0.05).Conclusion:Bridging treatment can achieve good therapeutic effect in patients with acute cerebral infarction,and the bedside TCD guidance can reduce the patient's nerve defect,promote the patient's functional recovery,and help improve the success rate of revascularization during the treatment process,reduce complication rate and mortality.
作者
江顺福
许捷
曹铭华
吴明超
邹永周
徐德红
徐鸿
毕建灿
吴义浪
JIANG Shunfu;XU Jie;CAO Minghua;WU Mingchao;ZOU Yongzhou;XU Dehong;XU Hong;BI Jiancan;WU Yilang(Jingdezhen No.1 People's Hospital,Jiangxi Province,Jingdezhen 333000,China)
出处
《中国医学创新》
CAS
2023年第8期139-143,共5页
Medical Innovation of China
关键词
床旁经颅多普勒超声
急性脑梗死
桥接治疗
Bedside transcranial
Doppler ultrasound
Acute cerebral infarction
Bridging treatment
