全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
-  2016 

经颅超声溶栓联合尿激酶治疗急性脑梗死患者的疗效观察 Efficacy of Transcranial Ultrasound Thrombolytic Therapy Combined with Urokinase in Patients with Acute Cerebral Infarction

Keywords: 脑梗死,尿激酶,经颅超声治疗

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的:研究脑梗死发生6-72h内,持续静脉注射尿激酶,同时加用超声溶栓治疗,对急性脑梗死最终临床结局的影响。方法:实验共纳入2013年2-11月间共90名患者,随机数表法分为3组,每组30例,实验组A(超声频率800kHz+尿激酶20万U/d连续进行5d治疗),实验组B(尿激酶20万U/d进行治疗,总共治疗5d),及对照组C(予常规抗血小板聚集治疗),同时所有受试者加用清除氧自由基等治疗。患者疾病发展情况依据改良的美国国立卫生院卒中量表(NIHSS)进行评估,分别在实验开始初以及实验结束时(14d后)记录患者评分结果,同时记录凝血功能相关指标变化。结果:实验结果显示,NIHSS评分,实验组A,评分从13.2±5.2降至6.7±1.6;实验组B,评分从13.6±5.7降至8.7±3.6;对照组C,评分从13.4±5.4降至9.7±3.1,实验组A情况改善最明显,P<0.05。凝血相关指标纤维蛋白原、D-二聚体、vWF及血小板CD62P在实验开始初及实验结束后,各组间无明显差异,并未提示出血风险。结论:急性脑梗死发生6-72h内,应用尿激酶+超声溶栓治疗对预后有有效改善作用,且在溶栓治疗过程中,应用尿激酶没有明显出血倾向

References

[1]  Rha JH,Saver JL.The impact of recanalization on ischemic stroke outcome:a meta-analysis[J].Stroke,2007,38(3):967-973.
[2]  Mitka M.Early treatment of ischemic stroke with intravenous tPA reduces disability risk[J].JAMA,2013,10(11):611-618.
[3]  Chen H,Zhu G,Liu N,et al.Low-dose tissue plasminogen activator is as effective as standard tissue plasminogen activator administration for the treatment of acute ischemic stroke[J].Curr Neurovasc Res,2014,11(1):62-67.
[4]  Smith DAB,Porter TM,Martinez J,et al.Destruction Thresholds of Echogenic Liposomes with Clinical Diagnostic Ultrasound[J].Ultrasound Med Biol,2007,33(5):797-809.
[5]  Tsivgoulis G,Saqqur M,Barreto A,et al.Validity of HAT score for predicting symptomatic intracranial hemorrhage in acute stroke patients with proximal occlusions:data from randomized trials of sonothrombolysis[J].Cerebrovasc Dis,2011,31(5):471-476.
[6]  Meunier JM,Holland CK,Lindsell CJ,et al.Duty Cycle Dependence of Ultrasound Enhanced Thrombolysis in a Human Clot Model[J].Ultrasound Med Biol,2007,33(4):576-583.
[7]  Barreto AD,Alexandrov AV,Shen L,et al.CLOTBUST-Hands Free:Pilot Safety Study of a Novel Operator-Independent Ultrasound Device in Patients With Acute Ischemic Stroke[J].Stroke,2013,44(12):3 376-3 381.
[8]  Mazighi M,Serfaty JM,Labreuche J,et al.Comparison of intravenous alteplase with a combined intravenous-endovascular approach in patients with stroke and confirmed arterial occlusion(RECANALISE study):a prospective cohort study[J].Lancet Neurol,2009,8(9):802-809.
[9]  Puetz V,Dzialowski I,Hill MD,et al.Intracranial thrombus extent predicts clinical outcome,final infarct size and hemorrhagic transformation in ischemic stroke:the clot burden score[J].Int J Stroke,2008,3(4):230-236.
[10]  Saqqur M,Uchino K,Demchuk AM,et al.Site of arterial occlusion identified by transcranial Doppler predicts the response to intravenous thrombolysis for stroke[J].Stroke,2007,38(3):948-954.
[11]  罗自勉.尿激酶型纤溶酶原激活物受体的研究进展及与脑室出血纤溶治疗的关系[J].医学综述,2011,17(22):3 395-3 397.
[12]  Sobolewski P,Sledzińska M,Szczuchniak W,et al.Intravenous thrombolysis patients with acute ischemic stroke—the analysis of the 100cases.PartⅡ.Neuroimaging,the analysis of hemorrhagic complications and deaths[J].Rzegl Lek,2012,69(6):242-246.
[13]  Soltani A,Singhal R,Obtera M,et al.Potentiating intra-arterial sonothrombolysis for acute ischemic stroke by the addition of the ultrasound contrast agents[J].Thromb Thrombolysis,2011,31(1):71-84.
[14]  Lee LH,Chryssidis S,Jannes J.Rescue therapy with local intra-arterial urokinase after poor clinical response with intravenous recombinant tissueplasminogen activator in acute ischaemic stroke[J].Intern Med J,2011,41(7):570-573.
[15]  Gao X.A clinical study of transcranial ultrasound as an adjuvant therapy for progressive cerebral infarction[J].Exp Ther Med,2013,5(4):1 244-1 246.
[16]  Dreier JP.The role of spreading depression,spreading depolarization and spreading ischemia in neurological disease[J].Nat Med,2011,17(4):439-447.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133