首页 | 官方网站   微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   31篇
  国内免费   1篇
  完全免费   3篇
医药卫生   35篇
  2015年   3篇
  2014年   14篇
  2013年   5篇
  2012年   2篇
  2011年   3篇
  2010年   1篇
  2009年   1篇
  2008年   3篇
  2007年   1篇
  2004年   1篇
  1999年   1篇
排序方式: 共有35条查询结果,搜索用时 93 毫秒
1.
BACKGROUND: Studies have demonstrated that immediate anticoagulation after thrombolysis can improve the prognosis of patients with acute cerebral infarction. However, the optimal timing and means of anticoagulation therapy remain unclear. OBJECTIVE: To observe the effects and safety of heparin treatment within 24 hours after intravenous thrombolysis for acute cerebral infarction. DESIGN: Observation experiment. SETTING: Department of Neurology, the 306 Hospital of Chinese PLA. PARTICIPANTS: Fifteen acute cerebral infarction patients complicated by moderate and severe neurologic function deficits within 6 hours after attack admitted to Department of Neurology, the 306 Hospital of Chinese PLA between January 2005 and December 2006 were recruited in this study. The involved patients, 11 male and 4 female, were aged 46–79 years. They all met the diagnosis criteria for various cerebrovascular diseases formulated by the 4th National Conference for Cerebrovascular Disease (1995) and confirmed as cerebral infarction by skull CT or MRI imageology. Informed consents were obtained from the patients or their relatives. METHODS: On admission, patients received thrombolysis with urokinase. Immediately after thrombolysis, skull CT was rechecked. Intracranial hemorrhage signs were not found by skull CT. Hemorrhage was also not found in skin, mucous membrane and internal organs. Six hours later, low-dose low-intensity heparin 4–8 IU/kg per hour was intravenously administrated for anticoagulation for 7–10 days successively. MAIN OUTCOME MEASURES: Neurologic function was evaluated before, immediately 6 hours and 14 days after thrombolysis by scoring standard of clinical neurologic function deficit degree for stroke patients (1995). Activities of daily living of patients with stroke were evaluated 90 days after thrombolysis by modified Rankin Scale. RESULTS: Fifteen involved patients participated in the final analysis. ① Comparison of clinical neurologic function deficit degree of patients at different time: Neurologic function deficit score at the end of thrombolysis was significantly lower than that before thrombolysis (t =3.45, P < 0.01). Neurologic function deficit score 6 hours after thrombolysis was higher than that at the end of thrombolysis, and neurologic deficits were increased, but no significant difference was found (P > 0.05). Neurologic function deficit score 14 days after thrombolysis was significantly lower than that before thrombolysis (t =4.769, P < 0.01). ② Therapeutic effect and modified Rankin scale results: 14 days after thrombolysis, 4 patients were basically cured, 7 significantly improved, 2 improved and 2 worsened. The total improvement rate of neurologic function deficit was 86.7%. Ninety days after thrombolysis, according to modified Rankin Scale, score was 0 to 2 in 12 patients (80%), 3 to 4 in 2 patients (13.3%) and 6 in 1 patient (6.7%). Complications of intracranial hemorrhage were not found in patients within 14 days after thrombolysis. CONCLUSION: Low-dose and low-intensity heparin applied within 24 hours after intravenous thrombolysis has good safety and efficacy in the treatment of acute cerebral infarction.  相似文献   
2.

Objective

Atrial fibrillation (AF) is associated with poor outcome after intravenous thrombolysis probably due to greater pretreatment stroke severity. We conducted this retrospective study to determine whether AF is an independent predictor for clinical outcome in patients stratified by initial stroke severity.

Methods

A total of 143 acute ischemic stroke patients who received intravenous thrombolysis within 3 h after onset were enrolled. The patients were categorized according to the baseline stroke severity by National Institute of Health Stroke Scale (NIHSS) score (≤10 vs. >10) and the presence of AF or not. Favorable 90-day outcome was defined as a modified Rankin Scale (mRS) score < 2.

Results

Among the 100 patients with severe stroke (NIHSS > 10), those with AF (n = 52) had a higher proportion of favorable 90-day outcome than those without AF (31% vs. 8%, P = 0.005). After adjustment for age, baseline glucose level, and onset to treatment time, the difference remained significant (odds ratio 5.80, 95% confidence interval 1.63–20.68). In patients with mild stroke (NIHSS ≤ 10), no difference in clinical outcome was found between AF (n = 20) and non-AF (n = 23) groups.

Conclusion

Presence of AF was associated with favorable 90-day outcome following intravenous thrombolysis in patients with severe stroke at baseline, while the association did not exist in patients with mild stroke.  相似文献   
3.
4.
黄镪  武剑 《中国卒中杂志》2013,8(3):190-196
本文对急性缺血性卒中静脉溶栓治疗后出现症状性脑出血并发症的危险因素及相关预测模型进行综述,通过比较不同的预测模型的特点及其应用价值,以期为临床实践获得可靠的指导急性缺血性卒中治疗决策和选择合适静脉溶栓病例的量化辅助工具  相似文献   
5.
目的 探讨心房颤动与急性缺血性卒中重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓致出血转化的相关性,分析房颤患者溶栓后出血转化的危险因素.方法 回顾性分析接受rt-PA静脉溶栓治疗的147例急性缺血性卒中患者,将入选病例分为非房颤组与房颤组,比较两组患者溶栓后出血转化(HT)的差异,采用单因素和logistic回归分析房颤患者溶栓后出血转化的危险因素.结果 147例入组患者中房颤患者66例,非房颤患者81例,房颤组HT与非房颤组比较差异有统计学意义[27.27% (18/66)与14.81% (12/81),x2 =3.071,P=0.028],房颤组症状性HT与非房颤组比较差异亦有统计学意义[12.12% (8/66)与3.70%(3/81),x2 =3.798,P=0.015],lo-gistic回归分析表明伴发房颤的患者基线收缩压高(OR=11.285,95%CI1.576-68.377,P=0.035)、基线NIHSS评分较高(OR =2.608,95%CI1.072-4.380,P=0.013)、早期头部CT有缺血改变(OR=1.595,95% CI1.164-3.258,P=0.023)、起病-溶栓时间(OTT)较长(OR =93.114,95%CI7.385-177.972,P=0.006)、溶栓24h内血压变异性大(收缩压变异性OR=18.638,95%CI1.433-65.634,P=0.004;舒张压变异性OR=21.449,95% CI1.528-56.420,P=0.003)与溶栓后发生HT显著相关.结论 房颤与静脉溶栓后HT具有相关性.基线收缩压高、基线NIHSS评分较高、早期头部CT有缺血改变、OTT较长、溶栓24h内血压变异性大是房颤患者静脉溶栓后发生HT的危险因素.  相似文献   
6.
目的:观察静脉溶栓治疗频发TIA为临床表现的急性脑梗死患者的疗效及预后。方法选择我院2008‐01‐01—2013‐12‐31以频发TIA为临床表现的急性脑梗死静脉溶栓患者56例为治疗组,选择同期未行溶栓治疗的患者30例为对照组,采用NIHSS评分及改良的Rankin评分评价早期疗效及远期预后。结果2组患者溶栓前ABCD2评分(6.12±3.49vs5.78±4.13,P=0.23)、DWI阳性率(39.28%vs36.67%,P=0.19)差别无统计学意义。溶栓后早期治疗有效率(51.78%vs30.00%,P=0.001)、远期预后预后良好率(48.21%vs33.33%,P=0.003)差别具有统计学意义。在出血转化率方面(8.93%vs6.67%,P=0.07)差异无统计学意义。结论以频发TIA为临床表现的急性脑梗死患者静脉溶栓治疗安全有效。  相似文献   
7.
目的:探讨静脉溶栓与抗凝治疗对心源性脑栓塞患者临床疗效及应用价值。方法选取76例心源性脑栓塞患者为研究对象,根据其入院顺序分成静脉溶栓组(A组,n=38)和抗凝组(B组,n=38)2组。对比2组患者治疗前后美国国立卫生院神经功能缺损评分(NIHSS)及神经功能缺损程度评分(NFDS)评估结果,记录其日常生活能力(ADL )。结果治疗后2组患者NIHSS及NFDS评分均较治疗前显著降低,其中A组降幅大于B组,差异具有统计学意义(P<0.05);2组病死率差异无统计学意义(P>0.05);但A组ADL优良率为50.0%,显著高于B组的23.7%,差异具有统计学意义(P<0.05)。结论对心源性脑栓塞患者予以阿替普酶静脉溶栓疗法,疗效确切,值得临床推广。  相似文献   
8.
目的 探讨心房纤颤(房颤)对急性脑梗死患者静脉溶栓近远期疗效的影响.方法 收集发病4.5h内(后循环梗死延长至6h)给予阿替普酶静脉溶栓治疗的急性脑梗死患者共60例作为研究对象,根据ECG结果分为房颤组及无房颤组.分别采用美国国立卫生研究院卒中量表(NIHSS)评分及改良的Rankin(mRS)评分评价早期疗效及远期预后.结果 房颤组与无房颤组相比,病前卒中或TIA发病率更高(P=0.042),发病时NIHSS评分更高(P=0.023);房颤组和无房颤组根据NIHSS评分在7d疗效有效率分别为68.42%和70.73%(P =0.58),根据mrs评分在90 d时预后良好率分别为63.15%和63.41%(P=0.47),早期疗效和晚期预后差别均无统计学意义.结论 合并房颤的卒中患者能够在静脉溶栓治疗中获益,房颤对急性脑梗死静脉溶栓治疗患者的近远期疗效无显著影响.  相似文献   
9.
目的 探讨前-后循环急性脑梗死静脉溶栓疗效差异及安全性评价.方法 对前-后循环急性脑梗死120例,其中前循环64例及后循环56例急性脑梗死进行rt-PA静脉溶栓治疗,比较两组间神经功能恢复情况;并通过Logistic回归分析影响急性脑梗死rt-PA静脉溶栓后出血风险的独立危险因素.结果 两组患者经溶栓治疗后24h、2w神经功能较溶栓治疗前均有明显恢复(P<0.01),两组之间溶栓治疗后24h神经功能恢复差异无统计学意义,但两组之间溶栓治疗后2w神经功能恢复差异有统计学意义(P<0.05);Logistic回归分析表明高血压病、心房纤颤、糖尿病及吸烟增加rt-PA静脉溶栓出血风险.结论 在急性脑梗死的rt-PA静脉溶栓治疗中,前循环疗效优于后循环,且高血压病、心房纤颤、糖尿病及吸烟影响rt-PA静脉溶栓疗效,有增加出血风险可能,从而影响患者日后生活质量.  相似文献   
10.
目的:探讨重组组织型纤溶酶原激活剂( rt-PA)静脉溶栓治疗急性脑梗死的临床效果及安全性。方法选择发病在4.5h内,平均2.86±0.8h内急性脑梗死患者73例,分为两组,溶栓组50例患者给予rt-PA 0.9mg· kg-1· d-1静脉溶栓,常规治疗组23例患者采用抗血小板聚集药物等治疗,比较溶栓和常规治疗后24h、7d及14d美国国立卫生研究院卒中量表( NIHSS)评分并记录不良反应。结果溶栓组治疗后24 h、7d及14d时,NIHSS评分较溶栓前及对照组均明显减少,差异有统计学意义( P<0.05);溶栓后头颅MRI/CT及临床表现提示未出现症状性脑出血。结论 rt-PA静脉溶栓治疗发病4.5h内脑梗死是安全有效的。  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司    京ICP备09084417号