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1、脑梗死患者r-tPA溶栓中TCD的变化及其临床意义【摘要】目的：探究脑梗死患者注入重组组织型纤溶酶原激活剂（r-tPA）进行溶栓治疗中经颅多普勒超声（TCD）的变化及其临床意义。方法：选择本院2014年5-11月收治的脑梗死且符合溶栓标准的患者76例，根据是否应用TCD监测将其分为观察组和对照组，每组各38例。观察组给予r-tPA溶栓联合TCD检测，对照组单纯给予r-tPA溶栓治疗。检测两组患者血管再通和颅内出血情况,测定两组不同时间段NIHSS评分和Barthel指数，观察治疗后并发症发生情况。结果：观察组血管再通率76.32%明显高于对照组的44.74%,差异有统计学意义（P
2、0.05）,而观察组治疗后7d和3周的NIHSS评分均明显低于对照组，且治疗后1个月和3个月的Barthel指数均明显高于对照组,总并发症发生率5.26%明显低于对照组的21.05%,差异均有统计学意义（P【关键词】脑梗死；溶栓；重组组织型纤溶酶原激活剂；经颅多普勒[Abstract]Objective：ToexplorethechangesoftranscranialDoppler（TCD）anditsclinicalsignificanceinrecombinanttissueplasminogenactivator（r-tPA）thrombolytictherapyofpa
3、tientswithcerebralinfarction.Method：76cerebralinfarctionpatientswhometthestandardofthrombolyticinourhospitalfromMay2014toNovember2014wereselected,andwererandomlydividedintotheobservationgroupandthecontrolgroupaccordingtowhethertheapplicationofTCDmonitoring,38casesineachgroup.Theobservationgro
4、upwastreatedwithr-tPAcombinedwithTCD,andthecontrolgroupwastreatedwithr-tPA.Therevascularizationandintracranialhemorrhagebetweenthetwogroupsweredetected,andtheNIHSSscoreandBarthelindexbetweenthetwogroupsindifferenttimeperiodsweredetermined,thecomplicationsaftertreatmentbetweenthetwogroupswereo
5、bserved.Result：Therevascularizationrateoftheobservationgroupwas76.32%,whichwassignificantlyhigherthan44.74%ofthecontrolgroup,thediffereneewasstatisticallysignificant(P0.05).TheNIHSSscoreoftheobservationgroup7daysand3weeksaftertreatmentweresignificantlylowerthanthoseofthecontrolgroup,theBarthe
6、lindexoftheobservationgroup1monthand3monthsaftertreatmentweresignificantlyhigherthanthoseofthecontrolgroup,thetotalcomplicationrateoftheobservationgroupwas5.26%,whichwassign讦icantlylowerthan21.05%ofthecontrolgroup,thedifferenceswerestatisticallysign讦icant（PFirst-author"saddress：TheFirstHospit
7、alAffiliatedtoNanhuaUniversity,Hengyang421001,Chinadoi：10.3969/j.issn.1674-4985.2016.02.015脑梗死是一种常见的脑血管疾病，早期死亡率较高，且大多数幸存者都伴有一定程度上的认知及运动等障碍。目前多采用溶栓疗法[1-2],而r-tPA作为脑梗死超早期唯一推荐使用的静脉溶栓药物，它可使1/3的患者血管再通，让15%的患者获得较好的预后。在脑梗死患者r-tPA溶栓中，TCD发挥着重要作用。本文通过T
