急性脑梗死早期尿激酶静脉溶栓治疗临床剖析.docVIP

急性脑梗死早期尿激酶静脉溶栓治疗临床剖析 　　【中图分类号】R743【文献标识码】A【文章编号】1005-2720(2009)09-0281-02 　　【摘要】目的：探讨尿激酶早期静脉溶栓治疗急性脑梗死的疗效及不良反应。方法：2005年1月～2008年6月来我院就诊的急性脑梗死病人58例随机分为两组，治疗组30例，对照组28例，对照组常规治疗，治疗组用尿激酶120~150万U+生理盐水100~250ml静脉滴注，后续治疗同对照组，总疗程2w。所有病例治疗前、治疗24h后、2w后根据1986年全国第二次脑血管学术通过的标准进行临床神经功能缺损程度及病残程度分级，并观察用药期间有无不良反应。结果：治疗组总有效率为90%，对照组为71.4%，两组比较具有显著性差异；两组治疗前与治疗后24h、2w时神经功能缺损评分比较：静脉溶栓治疗后24h、2w与治疗前比较差别均有统计学意义；治疗后24h与2w神经功能缺损评分差别无统计学意义；对照组治疗后24h、2w与治疗前比较差别无统计学意义；治疗后24h、2w静脉溶栓组与对照组相比差别有统计学意义；静脉溶栓组的不良反应 治疗后24h内颅内出血2例(6.7%)，皮肤黏膜出血6例(20.0%)。结论：急性脑梗死早期进行尿激酶静脉溶栓治疗的效果肯定，只要严格掌握适应证，不良反应较少，具有较高的安全性，而且操作简便、快速，价格相对低廉，适于在基层医院推广应用。 　　【关键词】静脉溶栓；脑梗死；尿激酶 　　 　　The clinical analysis of early intravenous thrombolysis with urokinase treating acute cerebral infarction.Feng Weiming.(Min?an health center of Fogang county，Guangdong 511690，China) 　　【Abstract】Objective：To study the effect and complication of early intravenous thrombolysis with urokinase(UK) treating acute cerebral infarction.Methods：58 cases of patients with acute cerebral infarction from January 2005 to June 2008，they were randomized into two groups，28 cases in control group(group 1)，30 cases in test group(group 2)，group 1 were given regular treatment，group 2 were injected UK1.2~1.5 MU+N.S100~250ml.Results：The recovery rate in thrombolysis-treated group was 90%，significantly higher than that in control group(71.4%)，There was significant difference of the scale of neurological function lack between 24 hours and 2 weeks after treatment with before treatment in group 2，There was no significant difference between 24 hours with 2 weeks after treatment in group 2，There was no significant difference of the scale of neurological function lack among 24 hours and 2 weeks after treatment and before treatment in group 1，There was significant difference of the scale of neurological function lack in 24 hours and 2 weeks after treatment between group 2 and group 1，complication of cerebral hemorrhage incidence in group 2 was 6.7% and skin bleeding was 20.0%