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目的探讨急性大脑中动脉闭塞性脑梗死后静脉溶栓的血管再通情况及其与预后关系。方法回顾性选取大脑中动脉闭塞性脑梗死静脉溶栓患者资料,分析溶栓后血管再通情况,并对再通组与无再通组的有效性及安全性结局进行比较分析。结果共入选67例患者,溶栓后血管再通率为55.2%,有再通组(37例)90 d随访获得生活自理(72.97%vs 43.33%,OR=3.5,P=0.014)及良好预后(64.86%vs 26.67%,OR=5.1,P=0.002)的比例均显著优于无再通组(30例),而两组的症状性颅内出血发生率及死亡率均无显著性差异。结论大脑中动脉闭塞性脑梗死患者静脉溶栓也具有较高的血管再通率,血管再通与预后显著相关,桥接治疗是最佳选择。
Objective To investigate the situation of recanalization of venous thrombolysis after acute middle cerebral artery occlusive cerebral infarction and its relationship with prognosis. Methods The data of thrombolytic patients with middle cerebral artery occlusive cerebral infarction were retrospectively analyzed, the situation of recanalization after thrombolysis was analyzed, and the effectiveness and safety of recanalization group and non-recanalization group were compared and analyzed. Results A total of 67 patients were enrolled in this study. The rate of recanalization after thrombolysis was 55.2%, and the recurrent group (n = 37) was followed up for 90 days (72.97% vs 43.33%, OR = 3.5, P = 0.014) (64.86% vs 26.67%, OR = 5.1, P = 0.002) were significantly better than no recanalization group (30 cases), while the incidence of symptomatic intracranial hemorrhage and mortality in both groups showed no significant difference. Conclusion Intravenous thrombolysis in patients with middle cerebral artery occlusive cerebral infarction also has a high rate of recanalization, and recanalization is significantly associated with prognosis. Bridging therapy is the best choice.