尿激酶静脉溶栓治疗早期急性脑梗死临床探究.doc

尿激酶静脉溶栓治疗早期急性脑梗死临床探究[摘要] 目的：探讨急性脑梗死尿激酶静脉溶栓治疗的临床疗效。方法：86例急性脑梗死病人随机分为溶栓组、对照组。溶栓组应用100万U尿激酶加入0.9％氯化钠溶液200 ml静滴, 30 min内滴完,溶栓12 h后用低分子肝素7 500 U皮下注射,1 次/24 h ,共5～7 d。对照组采用常规治疗方法。评价治疗前和治疗后24 h、2周及4周的神经功能缺损评分及临床疗效。结果：溶栓组临床疗效与对照组比较有显著性意义。结论：尿激酶静脉溶栓治疗早期急性脑梗死疗效好，相对安全。 [关键词] 急性脑梗死；尿激酶；静脉溶栓 [中图分类号] R743 [文献标识码]A [文章编号]1673-7210（2008）02（a）-039-02 The clinical study of urokinase in the therapy of thrombolysis in acute cerbral infarction Song Li (The Centeral Hospital of Liaoyang,Liaoyang 111000,China) [Abstract] Objective:To evaluate the therapeutic effects of treating acute cerbral infarction with urokinase.Methods:86 patients with acute cerbral infarction were divided into thrombolysis group and control group.1 000 000 U of urokinase in 200 ml normal saline were administered via intravenous drip infusion within 30 min，7 500 U of low molecular heparin were administered via hypodermic injection 12 h after thrombolysis per 24 h , totally 5 to 7 days. The cases of control group were adopted the common treatment. Neurologic impairment score and therapeutic effects were evaluated before thrombolysis、24 h、14 days after thrombolysis and 4 weeks after thrombolysis.Results:The therapeutic effect of thrombolysis group was significantly better than that of control group.Conclusion:Treating acute cerbral infarction with urokinase in the early stage is relatively safe and effective . [Key words] Acute cerbral infarction;Urokinase;Thrombolysis 急性脑梗死(acute ischemic stroke，AIS)是由于局部脑血流突然中断引起局部脑组织缺血坏死而致的相应神经功能缺损，AIS是最常见的脑血管病，溶栓治疗被认为是挽救缺血脑组织的最佳方案[1]。随着对其病理生理的不断深入了解，早期溶栓治疗被普遍应用于临床，大量研究结果表明早期大剂量尿激酶溶栓治疗对大多数早期急性脑梗死有效。2001～2006年，我院应用尿激酶静脉溶栓治疗早期急性脑梗死40例，效果满意，现报道如下： 1 资料与方法 1.1 临床资料 全部病例均符合全国第四界脑血管病学术会议修订的诊断标准[2]，并经CT或MRI检查确诊（早期脑出血患者除外），发病＜ 6 h，实验室检查无明显的出凝血障碍，将86例随机分为尿激酶治疗组和对照组。治疗组40例，男25例，女15例，年龄45～71岁，平均56岁；对照组46例，男28例，女18例，年龄41～73岁，平均57岁；两组患者病情、性别、年龄无明显差异，具有可比性。 1.2 方法 两组患者均给予20％甘露醇250 ml 静脉滴注，治疗组应用尿激酶100万单位尿激酶加入0.9％氯化钠溶液200 ml静滴， 30 min内滴完，溶栓12 h后用低分子肝素 7 500 U