替罗非班经动脉导管局部给药对溶栓时间窗超出的急性缺血性脑梗死患者局部血流及神经功能的影响

摘要

目的 探讨超出溶栓时间窗的急性缺血性脑梗死患者经动脉导管局部给予替罗非班治疗对其神经功能及局部血流的影响.方法 选择鹤壁市人民医院2016年10月至2018年4月收治的超出溶栓时间窗的急性缺血性脑梗死患者93例,以抽签法将其分为两组.传统组46例,行脑细胞保护、自由基清除等常规治疗;实验组47例,在传统组基础上加动脉导管替罗非班局部给药.治疗后2周,比较两组神经功能、生活能力及脑部血流情况.结果 治疗后2周,实验组日常生活能力量表(ADL)评分高于传统组,神经功能缺损量表(NIHSS)评分低于传统组(P<0.05);实验组两侧大脑中动脉、基底动脉血流均高于传统组,差异有统计学意义(P<0.05);两组均未出现明显不良反应(P>0.05).结论 经动脉导管局部给予替罗非班治疗可改善急性缺血性脑梗死患者的基底动脉及大脑中动脉血流,有利于患者生活能力的改善与神经功能的恢复,且安全可靠.%Objective To investigate the effects of local administration of tirofiban via arterial catheter on regional blood flow and neurological function in acute ischemic cerebral infarction patients with thrombolysis time window exceeding. Methods A total of 93 patients with acute ischemic cerebral infarction beyond the time window of thrombolytic therapy admitted to Hebi People's Hospital from October 2016 to April 2018 were selected. All patients were divided into two groups by drawing lots. Forty-six patients in traditional group received routine treatment such as brain cell protection and free radical scavenging, and 47 patients in experimental group were given tirofiban by arterial catheter on the basis of treatment for traditional group. Two weeks after treatment, the neurological function, living ability and cerebral blood flow were compared between the two groups. Results The activities of daily living ( ADL) score of experimental group was higher than that of traditional group, and the National Institutes of Health Stroke scale ( NIHSS ) score was lower than that of traditional group 2 weeks after treatment ( P<0. 05 ) . The blood flow of bilateral middle cerebral artery and basilar artery in experimental group was higher than that in traditional group, and the difference was statistically significant ( P<0. 05 ) . There was no obvious adverse reaction in the two groups ( P>0. 05 ) . Conclusions Local administration of tirofiban via arterial catheter can improve the blood flow of basilar artery and middle cerebral artery in patients with acute ischemic cerebral infarction. It is helpful to improve patients' living ability and recovery of nervous function, and it is safe and reliable.