经颅超声溶栓治疗超早期急性脑梗死的临床研究  

Clinical Study on Transcranial Ultrasound Thrombolysis in Treatment for Very Early Stage Patients with Acute Cerebral Infarction

作　　者：杜敢琴[1] 黄丽娜[1] 戚继胜[1] 高秀兰[1] 富奇志[1] 刚光霞[1] 郎鸿志[1] 

机构地区：[1]河南科技大学第一附属医院神经内科,中国471003

出　　处：《华夏医药》2006年第3期188-191,共4页Hua-xia Medicine

摘　　要：目的评价经颅超声溶栓治疗超早期急性脑梗死的临床疗效。方法急性脑梗死患者80例，均为发病6h内就诊者。同意溶栓治疗的患者66例随机分为3组：尿激酶（UK）溶栓组、经颅超声溶栓组、经颅超声加尿激酶溶栓组，每组22例。不同意溶栓治疗的患者14例作为对照组，只接受对症治疗。尿激酶100万U溶于生理盐水100ml静脉滴注，半小时内滴完。应用经颅超声溶栓治疗仪（频率：800kHz，0.75w／cm^2，脉冲超声）治疗，每天一次，每次20min，共10天。对各组治疗前後的神经功能缺损、日常生活能力及凝血功能进行分析比较。结果治疗后3个月，按欧洲卒中评分标准评分，经颅超声加尿激酶治疗组得分最高（95．33±3.37），对照组最低（79.17±8．73），即经颅超声加尿激酶治疗对恢复神经功能缺损的效果最显着；按Barthel指数评分，轻度残疾或无残疾的比例最高（85.71％），对照组最低（41.67％）。对凝血功能无影响。未见不良反应。结论经颅超声有溶栓作用，并可增强尿激酶的溶栓效果，能促使神经功能恢复；因此，经颅超声溶栓治疗急性脑梗死是一种安全、有效、操作简单的治疗方法。Objective To study the clinical outcome of transcranial ultrasound thrombolysis in the treatment for very early stage patients with acute cerebral infarction. Motlaods Eighty patients with acute cerebral infarction within 6 hours of the onset of stroke were enrolled in the trial. Written informed consent for participation in the trial was provided by all patients but the control. Sixty-six patients were randomizedly divided into three groups： urokinase thrombolysis group, transcranial ultrasound thrombolysis group and transcranial ultrasound plus urokinase thrombolysis group, in which 22 cases each included;and the control group included 14 patients received symptomatic therapy alone. A dose of urokinase 100 MU dissolved in normal saline 100 ml was given by intravenouse infusion within 30 min. Ultrasound （800 kHz, 0.75 W/cm^2, pulse wave）was given once a day for 10 days. Neurogical deficit, capacity of life and coagulation function were determined before and after treatment and at 3 months, and then performed statistical analysis. Results Three months after treatment the symptom improvement score in transcranial ultrasound plus urokinase group was the highest （95.33± 3.37）, while that in control group was the lowest （79.17± 8.73） on the score of the European Stroke Scale, That means the improvement of neurological deficit in transcranial ultrasound plus urokinase group was excellent. The rate of minimal or no disability in transcranial ultrasound plus urokinase group was higher than the control group （85.71% vs 41.67%） according to the scores on the Barthel Index.. No coagulation dysfunction and other adverse events were available. Conclusion The report suggests that transcranial ultrasound used may potentiate thrombolysis and enhance the thrombolytic effect of urokinase and have a favorable benifit in neurological deficit recovery. Therefore, transceranial ultrasound thrombolysis therapy is a safe, effective, and simple procedure to use for acute cerebral infarction.

关 键 词：经颅超声溶栓 尿激酶 脑梗死 

分 类 号：R743.33[医药卫生—神经病学与精神病学]