高压氧联合低剂量阿替普酶静脉溶栓治疗老年急性缺血性脑卒中的疗效 及对患者神经认知功能、凝血指标的影响.

Objective: To evaluate the efficacy of hyperbaric oxygen (HBO) combined with low dose alteplase (rtPA) intravenous thrombolysis in the treatment of elderly patients with acute ischemic stroke (AIS) and its impact on neurocognitive function and coagulation indicators. Methods: Sixty elderly patients with AIS admitted to our hospital from January 2020 to December 2022 were randomly divided into a control group and an observation group, with 30 patients in each group. The control group was treated with HBO+standard dose (0.9 mg/kg) rtPA intravenous thrombolysis, while the observation group was treated with HBO+low dose (0.6 mg/kg) rtPA. The therapeutic effects, neurocognitive function, and coagulation indicators of the two groups were evaluated and statistically compared. Results: There was no significant difference in the total effective rate between the two groups(P>0.05). Compared with pre thrombolysis, NIHSS significantly decreased and MMSE significantly increased in the two groups at 24 h and 7 d after thrombolysis(P<0.05), but there was no significant difference between the two groups(P>0.05). Compared to before thrombolysis, PT, APTT, TT, and D-D in the two groups increased to varying degrees at 7 days after thrombolysis, while FIB decreased significantly(P<0.05), while the increase/decrease amplitude in the observation group was smaller, with a significant difference compared to the control group(P<0.05). The bleeding rate in the observation group was significantly lower than that in the control group (6.67% vs 26.67%, P<0.05). There was no significant difference in mortality between the two groups(P>0.05). Conclusion: HBO combined with low dose and standard dose rtPA intravenous thrombolysis has a similar effect on improving neurocognitive function, clinical efficacy, and mortality in AIS patients, but low dose has a small impact on blood coagulation function and a low risk of bleeding. [ABSTRACT FROM AUTHOR]