| Background:Cerebral infarction is ischemic necrosis or softening of the brain supply ofblood circulation disorders, ischemia, hypoxia caused by the limitations of braintissue. Observed, acute cerebral infarction, the most harm to the health and lives ofthe elderly population has become one of the major diseases in China. If have atimely and very effective treatment and the prognosis of the patient’s quality of life isclosely associated. The most effective method is to restore the blood supply of thebrain tissue thrombolysis. This method has so far gone through more than20years.Meanwhile after a large number of drugs, and confirmed in a number oflarge-scale clinical trials, thrombolysis can be used as a treatment of choice for thetreatment of acute cerebral infarction. Evidence-based guidelines, the A levelrecommended by acute cerebral infarction preferred treatment is set to4.5hourintravenous recombinant tissue-type plasminogen activator treatment. Althoughthere have come to realize the importance of intravenous thrombolytic therapy, butdue to various reasons, in our current study was to be able to get intravenousthrombolytic therapy of acute ultra-early groups of patients with cerebral infarctionless than1%. Some of our studies have shown that a comparative study, thesestudies were given rt-PA intravenous thrombolysis treatment efficacy and safety ofclinical commonly used drugs (sodium Ozagrel, edaravone) proposedrt-PAthrombolytic therapy in acute cerebral infarction treatment safer and more effectivethan routine clinical drug (sodium Ozagrel, edaravone). But the use of conventionaldrugs in the treatment of acute over reports of acute cerebral infarction comparativestudy of the efficacy and safety of rt-PA with sodium ozagrel less.Objective: This study given application rt-PA intravenous thrombolytic drug treatment ofacute cerebral infarction, and at the same time with conventional intravenous toOzagrel sodium drug treatment of acute patients with early-control study observed.Primary purpose of further study rt-PA intravenous thrombolysis drugs and domesticclinical commonly used drugs (sodium ozagrel) and other conventional drugtreatment effectiveness and safety of acute cerebral infarction patients, and givestatistics and assessment, early for domestic norms application of rt-PA treatment ofacute ultra cerebral infarction thrombolytic therapy in evidence-based.Methods:The test for randomized controlled clinical studies were analyzed from January2010to December2012in our hospital neurology diagnosis and treatment ofDivision II in full compliance with indications of thrombolytic therapy in acutecerebral infarction patients, rt-PA group20cases and20cases of the control group,the incidence time of4.5h. rt-PA thrombolysis group4.5h time window, a dose of0.9mg per kg of body weight (maximum dose of90mg), the first intravenous bolusinjection of10per cent (one minute), the remaining six consecutive drops finished inten minutes. Thrombolysis after24hours to give a review of routine coagulation,head CT scan. Patients in the control group while giving the conventional drugOzagrel Sodium Chloride Injection80mg,2times a day for14days. For theimprovement of cell metabolism, eliminate edema, drug free radical scavenging twogroups are the same. Time assessment of each patient’s neurological deficit or theextent of recovery, a clear effect. Were used (1) United States National Institutes ofHealth Stroke Scale (NIHSS) timely evaluation before thrombolysis, immediatelyafter thrombolysis,24h,7d,14d,21d,3-month,6-month efficacy;2. Activities ofdaily living scale Barthel Index (BI index) score, patients were given assessmentthrombolytic Fourteen days after the21days, three months, six months of dailyliving. The mRS score method after thrombolysis1month,3months,6months latergiven to assess the patient’s degree of disability, to further clarify the prognosis ofpatients. Thrombolysis within14days after the occurrence of secondary intracranial hemorrhage rate, mortality, vascular occlusion rate, drug allergic reaction rate toevaluate the safety of thrombolytic drugs.Result:1.rt-PA group and the control group the sex ratio,age,past statisticallydifferent(P>0.05); rt-PA group and the control group pretreatment NIHSS scorerespectively15.15±3.72，14.95±2.24,showed the treatment was no significantdifference,Each point in time after treatment NIHSS score have shown a downwardtrend,2.After treatment for6month,the NIHSS score respectively1.2±1.64，6.4±5.51.Scores have significant differences.3. According to the comparison resultsof rt-PA group and the control group of daily living shown:the BI scores graduallyimproving. After treatment for6month,the P=0.002，(P<0.05). the scores havesignificant differences.4. According to the comparison results of rt-PA group and thecontrol group of disabled features shown: the mRS effective rates graduallyimproving. After the rt-PA group treatment for1,3,6month, the mRS effective ratesshown that70%,80%,95%.Both higher than the control group.(P<0.01). the scoreshave significant differences.5. rt-PA group and the control group no one case havethe complications.(p<0.05), showed the result was no significant difference.6. Withthrombolytic therapy group, the control group1,2, and3months after treatmentMRA vascular recanalization and reocclusion analysis showed that the dissolvingtreatment group，compared with the solution according to group, P>0.01, thedifference was not statistically significant; forward occlusion. Thrombolysis groupcompared with control group, P <0.01, the difference was statistically significant,indicating that the thrombolysis group than the control group treatment of acutecerebral infarction is more effective;7.by treatment immediate of DWI, PWI, MRAcomparison, analysis of infarct size was reduced and the vascular recanalization rate,results showed that the treatment group compared with the control group, P <0.01,the difference was statistically significant, thrombolysis group than the control groupmore effective treatment of acute ultra-early cerebral infarction. Conclusion:This study shows that: application of rt-PA intravenous thrombolytic treatment of acutecerebral infarction significantly improved patient outcomes, reduce morbidity, improve quality oflife. The two methods are safe treatment of ultra-early acute cerebral infarction. Thrombolyticindications of acute cerebral infarction patients recommended early use of recombinanttissue-type plasminogen activator, to obtain the best effect. |
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