rt-pa静脉溶栓和双抗治疗轻度急性缺血性脑卒中临床观察

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1、授予单位代码10089学号或申请号15383中国图书分类号R743HebeiMedicalUniversity硕士学位论文学术学位rt-PA静脉溶栓和双抗治疗轻度急性缺血性脑卒中临床观察研究生：吴慧君导师：张祥建教授专业：神经病学二级学院：第二医院2018年3月目录中文摘要········································································································1英文摘要·········

2、·······························································································4英文缩写········································································································7研究论文rt-PA静脉溶栓和双抗治疗轻度急性缺血性脑卒中临床观察前言················

3、························································································8材料与方法····························································································9结果··································································

4、······································13附表········································································································17讨论········································································································2

5、1结论········································································································25参考文献································································································25附录··········································

6、·····························································30综述急性轻度缺血性脑卒中的治疗新进展及研究现况··························32致谢················································································································43个人简历·····················

7、···················································································44rt-PA静脉溶栓和双抗治疗轻度急性缺血性脑卒中临床观察摘要目的：相关循证医学表明溶栓治疗是急性脑梗死当前最有效的治疗方法，然而由于各种原因，许多在时间窗内到达医院的急性脑梗死患者未能[1]接受溶栓治疗。轻型卒中溶栓率更是偏低。在临床工作中，一般认为轻型卒中患者预后良好，加之溶栓有一定的出血风险，且很多患者及家属对溶栓不了解，惧怕出血风险

8、，经常拒绝溶栓，因而常常不予轻型卒中患者溶栓治疗。而且，2010年的指南要求NIHSS≥4分才建议给予溶栓治疗，随后经研究发现，轻型卒中的预后并不如大家预测的那么好，约有25%[2]的轻型卒中会恶化，遗留残疾。随后的美国的指南进一步扩大了范围，不局限于NIHSS评分，只要求存在可测的神经功能缺损就可进行静脉溶栓治疗。同时，2013年天坛医院王拥军教授领衔的CHANCE研究结果表[3]明，发病24小时内给予治疗的TIA或轻型脑卒