Efficacy Evaluation Study Of Extra-time Window Arterial Thrombolysis In The Treatment Of Acute Anterior Circulation Cerebral Infarction

Objective:A retrospective study was conducted to evaluate the clinical efficacy and prognosis of arterial thrombolysis in the treatment of acute anterior circulation cerebral infarction(within 6-12 hours of onset),and to provide a scientific basis for the clinical application of extra-time window treatment for such patients.Methods:According to the inclusion and exclusion criteria,a total of 72 patients were enrolled,including 36 patients in the observation group and 36 patients in the control group.The observation group was given 500000 IU urokinase for arterial thrombolysis under DSA monitoring,and the control group was given conventional medicine.NIHSS scores at 24 hours,7 days and 14 days after treatment,as well as MRS scores before treatment and 3 months after discharge were assessed in both groups.The incidence of symptomatic intracranial hemorrhage and the mortality at 3 months after discharge were recorded in both groups.SPSS Statistics 20.0 was used for analysis and statistical data.Results:Before treatment,there was no significant difference in NIHSS score and MRS score between the two groups(P>0.05).24 hours after treatment,7 days after treatment and14 days after treatment,the NIHSS scores in both groups gradually decreased,and the differences between groups were statistically significant(P<0.05).Three months after discharge,the MRS score of the observation group was significantly lower than that of the control group,and the difference was statistically significant(P<0.05).MRS score ≤2 in the observation group accounted for 61.11%,which was significantly higher than that in the control group(36.11%),and the difference was statistically significant(P<0.05).The overall effective rate of the observation group(88.9%)was higher than that of the control group(75.0%),and the difference was statistically significant(P<0.05).No serious adverse reactions such as symptomatic intracranial hemorrhage occurred in both groups during the treatment.The case fatality rate 3 months after discharge was generally similar between the two groups,both of which were 5.56%,with no significant difference(P>0.05).Conclusion:The overall efficacy of arterial thrombolysis with 500,000 IU urokinase in the treatment of acute anterior circulation cerebral infarction(within 6-12 hours of onset)is superior to conventional drug therapy.For appropriately selected patients,ultra time window arterial thrombolysis can reduce the disability rate of patients,improve the ability of independent living,and the prognosis of 3 months is better than conventional treatment.This treatment is relatively safe and does not increase the incidence of intracranial symptomatic bleeding and the long-term mortality rate.It is worth popularizing in clinical application.