[1]田 洪,郝 磊,宋 川,等.急性脑梗死动脉溶栓治疗的疗效相关因素探讨[J].介入放射学杂志,2014,(10):839-842.
 TIAN Hong,HAO Lei,SONG Chuan,et al.Therapeutic effect of arterial thrombolysis for acute cerebral infarction: analysis of related factors[J].journal interventional radiology,2014,(10):839-842.
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急性脑梗死动脉溶栓治疗的疗效相关因素探讨 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2014年10期
页码:
839-842
栏目:
神经介入
出版日期:
2014-10-25

文章信息/Info

Title:
Therapeutic effect of arterial thrombolysis for acute cerebral infarction: analysis of related factors
作者:
田 洪 郝 磊 宋 川 张玉波 周虎传 刘 磊
Author(s):
TIAN Hong HAO Lei SONG Chuan ZHANG Yu bo ZHOU Hu chuan LIU Lei.
Cerebrovascular Diseases Center, No.324 Hospital of Chengdu Military Region, Chongqing 400020, China
关键词:
【关键词】 脑梗死 动脉溶栓 时间窗 疗效 侧支循环
文献标志码:
A
摘要:
【摘要】 目的 探讨急性脑梗死动脉溶栓治疗效果与残存正向血流的关系。方法 回顾性分析2009年1月—2013年12月进行动脉溶栓治疗的40例急性前循环脑梗死患者的临床资料。按照残存正向血流分为A、B组,A组23例,有正向血流或(和)侧支循环,B组17例,无正向血流和侧支循环,比较两组患者溶栓后14 d NIHSS评分和出血性转化情况。结果 A组拥有残存正向血流或(和)侧支循环,21例(91.3%)完全或部分再通,发生非症状性出血性转化1例,溶栓前NIHSS评分12.69 ± 3.88,溶栓后14 d NIHSS评分6.05 ± 3.25;B组无残存正向血流和侧支循环,15例(88.2%)完全或部分再通,发生1例非症状性出血性转化,1例症状性出血性转化(溶栓后7 h发生大量脑出血死亡),溶栓前NIHSS评分13.51 ± 4.19,溶栓后14 d NIHSS评分8.68 ± 5.16,两组比较差异有统计学意义(P < 0.05);A组治疗14 d后显效率为68.1%,有效率为86.3%,而B组的显效率为43.8%,有效率为56.3%,提示A组临床效果较B组好。结论 急性脑梗死动脉溶栓的效果不仅与时间窗密切相关,还与残存正向血流有关;残存正向血流多的患者动脉溶栓后临床效果好,出血风险低。

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备注/Memo

备注/Memo:
(收稿日期:2014-04-30)
(本文编辑:李 欣)
更新日期/Last Update: 2014-10-21