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目的:探讨多模式CT指导下静脉溶栓与动脉溶栓治疗急性脑梗死与预后的相关性。方法:2014-02-2016-04选择在我院诊治的急性脑梗死患者86例,根据多模式CT指导具有溶栓治疗指征,用电脑简单随机化方法把患者分为观察组与对照组各43例,对照组给予动脉溶栓,观察组给予静脉溶栓,观察2组预后情况。结果:溶栓后观察组与对照组的显效率分别为69.8%和46.5%,观察组的显效率明显高于对照组(P<0.05)。观察组与对照组溶栓后NIHSS评分分别为(6.13±2.18)分和(10.44±3.20)分,都明显低于溶栓前的(18.32±3.10)分和(18.83±2.78)分,观察组溶栓后评分也明显低于对照组(P<0.05)。观察组溶栓期间的肠系膜栓塞、消化道出血、脑出血、肺部感染、尿路感染等并发症发生率为7.0%,对照组为32.6%,观察组明显少于对照组(P<0.05)。结论:相对于动脉溶栓,多模式CT指导下静脉溶栓治疗急性脑梗死具有更好的安全性,能提高脑神经,从而促进预后的改善,有很好的应用价值。
Objective: To investigate the correlation between multi-modal CT-guided intravenous thrombolysis and arterial thrombolysis in the treatment of acute cerebral infarction and prognosis. Methods: Totally 86 patients with acute cerebral infarction who were diagnosed and treated in our hospital from February 2014 to June 2016 were enrolled in this study. According to multi-modality CT guidance, they were given thrombolytic therapy indications. Patients were divided into observation group and control group by simple randomized computerized method 43 cases, the control group given arterial thrombolysis, intravenous thrombolysis in the observation group, the prognosis of the two groups were observed. Results: The effective rates of observation group and control group after thrombolytic therapy were 69.8% and 46.5%, respectively. The apparent efficiency of the observation group was significantly higher than that of the control group (P <0.05). The NIHSS scores of the observation group and the control group after thrombolysis were (6.13 ± 2.18) and (10.44 ± 3.20) points, respectively, which were significantly lower than those before the thrombolysis (18.32 ± 3.10) and (18.83 ± 2.78) After thrombolysis score was significantly lower than the control group (P <0.05). The incidence of complications such as mesenteric embolism, gastrointestinal bleeding, cerebral hemorrhage, pulmonary infection and urinary tract infection in the observation group was 7.0% in the thrombolysis group and 32.6% in the control group, which was significantly lower in the observation group than in the control group (P <0.05) . Conclusion: Compared with arterial thrombolysis, multi-modal CT-guided intravenous thrombolysis has better safety in treating acute cerebral infarction, improving cranial nerves and improving prognosis, which is of great value.