多模式mri指导缺血性脑卒中超急性期静脉溶栓治疗的研究

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1、授予单位代码10089学号或申请号13789HebeiMedicalUniversity硕士学位论文在职科学学位多模式MRI指导缺血性脑卒中超急性期静脉溶栓治疗的研究学位申请人：刘丽娟导师：卢宝全教授专业：神经病学二级学院：唐山工人医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师(或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果,其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学

2、，试验材料、原始数据、申报的专利等知识产权均归河北医科大学所有。否则,承担相应法律责任。研究生签名导师签章：&令》二级学院领导盖章：乂,r年文月y日河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果,指导教师对此进行了审定。本论文由本人独立撰写,文责自负。研究生签名：导师签章：^i年丁月q日目录中文摘要······················································

3、·······················1英文摘要·············································································4英文缩写·············································································7研究论文多模式MRI指导缺血性脑卒中超急性期静脉溶栓治疗的研究前言··········································

4、···································8资料与方法····································································8结果·············································································10附图······································································

5、·······11附表·············································································12讨论·············································································14结论·············································································19参考文献·······

6、································································20综述缺血性脑卒中超急性期的治疗···········································24致谢···················································································35个人简历··············································

7、·······························36中文摘要多模式MRI指导缺血性脑卒中超急性期静脉溶栓治疗的研究摘要目的：应用多模式MRI弥散加权成像（DWI）/液体衰减反转恢复序列（FLAIR）不匹配现象来筛选起病4.5h-9h缺血性脑卒中患者中的超急性期者，并给予重组组织型纤溶酶原激活剂（r-tPA）静脉溶栓治疗，观察疗效及安全性。从而探讨多模式MRI在超过时间窗（4.5小时）但仍处于病理生理期时间窗内的超急性期缺血性脑卒中静脉溶栓治疗中的指导作用。方法：选择我院2012年1月—2014年11月急诊收

8、治的发病4.5h-9h急性缺血性脑卒中患者120例（年龄在18-80岁之间，而且已经由CT排除脑出血、脑肿瘤和明显低密度梗死灶，NIHSS评分＜25分），且无以下溶栓治疗禁忌症：（1）近期（3个月内）有明显的头部外伤或卒中史；（2）7天内有动脉穿刺史，穿刺部位难以压迫；（3）临床怀疑蛛网膜下腔出血；（4）近期有脊髓内