刘静

[摘要] 目的 研究超選择性动脉溶栓治疗急性大脑中动脉脑梗死的疗效和安全性。 方法 选取150例急性大脑中动脉脑梗死患者，按照随机数表法分成观察组和对照组，每组75例，对照组行常规的巴曲酶治疗，观察组行超选择性动脉溶栓治疗，对比两组患者治疗前后的神经功能缺损评分、治疗后血流动力学指标和治疗满意度情况。结果 两组患者经治疗后，神经功能缺损评分与治疗前相比，均明显降低，而观察组患者治疗后的神经功能缺损评分显著低于对照组，差异均有统计学意义（P<0.05），观察组患者治疗后的纤维蛋白原、全血高切黏度、全血低切黏度、血细胞比容、血浆黏度等血流动力学指标均低于对照组，差异均有统计学意义（P<0.05），观察组患者的治疗满意度为94.67%，明显高于对照组的72.00%，差异有统计学意义（P<0.05）。 结论 超选择性动脉溶栓治疗急性大脑中动脉脑梗死的疗效显著，治疗满意度较高，值得在临床上推广应用。

[关键词] 脑梗死；动脉溶栓；治疗满意度；安全性

[中图分类号] R743.3 [文献标识码] B [文章编号] 1673-9701（2017）27-0052-03

Study on the efficacy and safety of superselective arterial thrombolysis in the treatment of acute middle cerebral artery infarction

LIU Jing

Department of Neurology，Zouping County Peoples Hospital in Shandong，Zouping 256200，China

[Abstract] Objective To study the efficacy and safety of superselective arterial thrombolysis in the treatment of acute middle cerebral artery infarction. Methods A total of 150 patients with acute middle cerebral artery infarction were selected and randomly divided into observation group and control group according to the random number table method， 75 cases in each groups. The control group was given conventional batroxobin， and the observation group was given super-selective arterial thrombolytic therapy. The scores of neurological deficits before and after treatment， hemodynamic parameters after treatment and treatment satisfaction were compared between the two groups. Results After treatment， the scores of neurological deficits were significantly lower than those before treatment， and the scores of neurological deficits in the observation group after the treatment were significantly lower than those in the control group， the difference was statistically significant（P<0.05）. The hemodynamic parameters such as fibrinogen， whole blood high shear viscosity， whole blood low shear viscosity， hematocrit and plasma viscosity in the observation group were lower than those in the control group after the treatment， and the differences were statistically significant（P<0.05）. The satisfaction rate in the observation group was 94.67%， significantly higher than that of 72.00% in the control group， and the difference was statistically significant（P<0.05）. Conclusion Super-selective arterial thrombolysis is effective in the treatment of acute middle cerebral artery infarction， and the treatment satisfaction is high， which is worthy of clinical promotion and application.

[Key words] Cerebral infarction； Arterial thrombolysis； Treatment satisfaction； Safetyendprint

急性大脑中动脉脑梗死是缺血性卒中常见的类型，通常由局部脑组织血容量减少发生缺血性坏死导致，临床预后较差，患者的病死率较高[1]。急性缺血性卒中的缺血区分成周边区和中心区，周边区的脑血流情况在形态和功能损害之间为缺血半暗带，中心区缺血发生的短时间就会导致神经细胞的死亡[2]。因此，在神经组织没有坏死前采取有效的救治措施，能够很好的改善预后，其为溶栓治疗的缺血半暗带理论，临床上溶栓治疗有动脉溶栓和静脉溶栓，静脉溶栓操作简单，但需要很大的药物剂量，而动脉溶栓治疗使用的药量较少，而且能够促进血管再通，从而降低患者的病死率[3]。

1资料与方法

1.1 一般资料

选取2016年3月～2017年3月我院就诊或住院治疗的150例急性大脑中动脉脑梗死患者，纳入标准[4]：符合急性大脑中动脉脑梗死诊断标准（神经系统症状和体征符合大脑中动脉供血区脑梗死），同时经过MRI、CT、脑血管造影等影像学检查确诊；……