目的观察早期静脉溶栓联合机械取栓对急性缺血性脑卒中患者的临床效果及对预后的影响。方法将2014年1月—2016年12月本院收治的200例急性缺血性脑卒中患者采取随机数字表法等分为观察组和对照组。对照组在发病4.5h内给予静脉溶栓,8h内...目的观察早期静脉溶栓联合机械取栓对急性缺血性脑卒中患者的临床效果及对预后的影响。方法将2014年1月—2016年12月本院收治的200例急性缺血性脑卒中患者采取随机数字表法等分为观察组和对照组。对照组在发病4.5h内给予静脉溶栓,8h内给予动脉溶栓治疗;观察组在发病3.0~4.5h内行静脉溶栓,8h内行机械取栓术治疗。①治疗后3周根据美国国立卫生研究院卒中量表(national Institute of Health stroke scale,NIHSS)评分评估两组临床疗效;②比较两组治疗前及治疗后24h、3d、3周NIHSS评分;③治疗后3周比较两组血管开通及取栓后血管狭窄侧支代偿率;④治疗后即刻及治疗后3周观察两组血管灌注改良脑梗死溶栓血流分级(modified thrombolysis in cerebral infarction,mTICI);⑤治疗后3周观察两组再出血率、再闭塞率、病死率。结果①治疗3个月后观察组临床总有效率为93.00%高于对照组的74.00%(P<0.05)。②治疗后24h、3d、3周两组NIHSS评分较治疗前均降低,且随着治疗时间的延长NIHSS评分逐渐降低(P<0.05);观察组术后24h、3d、3周NIHSS评分低于对照组相同时间(P<0.05或P<0.01)。③治疗3周后,观察组血管开通率、取栓后血管狭窄侧支代偿率均高于对照组(P<0.05)。④两组治疗后3周mTICI分级≥2b级比例均较术后即刻升高,且治疗后即刻、治疗后3周观察组mTICI分级≥2b级比例高于对照组,差异均有统计学意义(P<0.05或P<0.01)。⑤治疗后3周,观察组再出血率、再闭塞率、病死率均低于对照组(P<0.05)。结论早期静脉溶栓联合机械取栓治疗急性缺血性脑卒中可以提高临床效果,促进患者神经功能恢复,降低致残率及致死率,促进患者早日康复;并提示严格掌握手术适应证、选择合理手术时间、充分术前评估对治疗效果的重要性。展开更多
Although the late Quaternary slip rate of the Northern Margin Fault of the Huaizhuo Basin(NFHB)was studied approximately 30 years ago using thermoluminescence and geomorphic methods,the underlying uncertainty cannot b...Although the late Quaternary slip rate of the Northern Margin Fault of the Huaizhuo Basin(NFHB)was studied approximately 30 years ago using thermoluminescence and geomorphic methods,the underlying uncertainty cannot be neglected,considering the limitations resulting from age and displacement measurements.Accordingly,we attempted to re-estimate the late Quaternary slip rate of the NFHB using high-precision remote sensing image interpretation,large-scale geological and geomorphic mapping,paleoseismic analysis,and Quaternary geochronology testing.The results,based on stratigraphic dislocation and age constraint in the trenches,show that the present deformation of the NFHB has been dominated by the extension,with a vertical slip rate~0.04-0.11 mm/a.We estimate a vertical slip rate of~0.06 mm/a,with an R^(2) value of~0.91,which is much lower than the~0.5 mm/a result estimated previously.There are three possible reasons for this discrepancy.The first is the limitation resulting from dating and displacement measurements in earlier studies;the second is the slip decomposition caused by multiple branches of the NFHB,which leads to the low slip rate observed at a single fault;and third possible explanation is that the fault may be locked at present with a low slip rate,which means that the earthquake hazard of the NFHB cannot be ignored,and more in-depth research,such as geodetic and intensive observations of earthquake precursors,is urgently needed.This discovery poses a new challenge for the active study of the NFHB and the northeast corner of the Ordos Plateau in the North China Block.展开更多
文摘目的观察早期静脉溶栓联合机械取栓对急性缺血性脑卒中患者的临床效果及对预后的影响。方法将2014年1月—2016年12月本院收治的200例急性缺血性脑卒中患者采取随机数字表法等分为观察组和对照组。对照组在发病4.5h内给予静脉溶栓,8h内给予动脉溶栓治疗;观察组在发病3.0~4.5h内行静脉溶栓,8h内行机械取栓术治疗。①治疗后3周根据美国国立卫生研究院卒中量表(national Institute of Health stroke scale,NIHSS)评分评估两组临床疗效;②比较两组治疗前及治疗后24h、3d、3周NIHSS评分;③治疗后3周比较两组血管开通及取栓后血管狭窄侧支代偿率;④治疗后即刻及治疗后3周观察两组血管灌注改良脑梗死溶栓血流分级(modified thrombolysis in cerebral infarction,mTICI);⑤治疗后3周观察两组再出血率、再闭塞率、病死率。结果①治疗3个月后观察组临床总有效率为93.00%高于对照组的74.00%(P<0.05)。②治疗后24h、3d、3周两组NIHSS评分较治疗前均降低,且随着治疗时间的延长NIHSS评分逐渐降低(P<0.05);观察组术后24h、3d、3周NIHSS评分低于对照组相同时间(P<0.05或P<0.01)。③治疗3周后,观察组血管开通率、取栓后血管狭窄侧支代偿率均高于对照组(P<0.05)。④两组治疗后3周mTICI分级≥2b级比例均较术后即刻升高,且治疗后即刻、治疗后3周观察组mTICI分级≥2b级比例高于对照组,差异均有统计学意义(P<0.05或P<0.01)。⑤治疗后3周,观察组再出血率、再闭塞率、病死率均低于对照组(P<0.05)。结论早期静脉溶栓联合机械取栓治疗急性缺血性脑卒中可以提高临床效果,促进患者神经功能恢复,降低致残率及致死率,促进患者早日康复;并提示严格掌握手术适应证、选择合理手术时间、充分术前评估对治疗效果的重要性。
基金The research and development project of Beijing Disaster Prevention Technology Co.,Ltd.(FZKJYF202201)funded this work.
文摘Although the late Quaternary slip rate of the Northern Margin Fault of the Huaizhuo Basin(NFHB)was studied approximately 30 years ago using thermoluminescence and geomorphic methods,the underlying uncertainty cannot be neglected,considering the limitations resulting from age and displacement measurements.Accordingly,we attempted to re-estimate the late Quaternary slip rate of the NFHB using high-precision remote sensing image interpretation,large-scale geological and geomorphic mapping,paleoseismic analysis,and Quaternary geochronology testing.The results,based on stratigraphic dislocation and age constraint in the trenches,show that the present deformation of the NFHB has been dominated by the extension,with a vertical slip rate~0.04-0.11 mm/a.We estimate a vertical slip rate of~0.06 mm/a,with an R^(2) value of~0.91,which is much lower than the~0.5 mm/a result estimated previously.There are three possible reasons for this discrepancy.The first is the limitation resulting from dating and displacement measurements in earlier studies;the second is the slip decomposition caused by multiple branches of the NFHB,which leads to the low slip rate observed at a single fault;and third possible explanation is that the fault may be locked at present with a low slip rate,which means that the earthquake hazard of the NFHB cannot be ignored,and more in-depth research,such as geodetic and intensive observations of earthquake precursors,is urgently needed.This discovery poses a new challenge for the active study of the NFHB and the northeast corner of the Ordos Plateau in the North China Block.
