尿激酶静脉溶栓治疗急性脑梗死50例疗效观察  

Observation on therapeutic efficacy of urokinase intravenous thrombolysis in treating 50 cases with acute cerebral infarction

作　　者：王维炼 高士学 侯清奎 时建华[1] 徐大勇[1] 蔡鹏[1] 

机构地区：[1]山东省费县人民医院

出　　处：《中西医结合实用临床急救》1998年第8期350-353,共4页

摘　　要：目的：观察尿激酶（ＵＫ）静脉溶栓治疗急性脑梗死的疗效及安全性。方法：急性脑梗死患者５０例予ＵＫ１５×１０５Ｕ加入５％葡萄糖１００ｍｌ中３０分钟内静滴完，同时口服阿斯匹林０．３ｇ／ｄ（３日后改为７５ｍｇ／ｄ），溶栓开始１２小时后皮下注射肝素７５００Ｕ（之后每１２小时１次，连用３日）。于注射２４小时后判定疗效。结果：５０例患者经ＵＫ静脉溶栓治疗总有效率为９０．０％，其中４２例发病６小时内溶栓者及８例发病６小时～１２小时溶栓者总有效率分别为９２．９％和７５．０％，二者比较无显著性差异（ｕ＝１．５５，Ｐ＞０．０５）；但其基本痊愈率差异显著（ｕ＝２．２６，Ｐ＜０．０５）。老年患者（≥６０岁）总有效率及基本痊愈率均明显低于＜６０岁患者（ｕ＝２．０１，Ｐ＜０．０５及ｕ＝２．００，Ｐ＜０．０５）。本组患者ＵＫ静脉溶栓后脑出血（均为梗死灶内斑片状出血）、脑水肿及皮肤粘膜轻度出血发生率分别为６．０％、６．０％和４．０％，均未出现过敏反应、再梗死及死亡。结论：ＵＫ静脉溶栓治疗急性脑梗死效果可靠、安全，并且溶栓开始至发病时间越短、年龄越小。Objective:To observe the therapeutic efficacy and safeness of urokinase (UK) intravenous thrombolysis on acute cerebral infarction (ACI).Methods:Fifty cases of ACI were treated with UK (15×10 5 U) add to 5% glucose 100 ml intravenous drip within 30 minutes.At the same time, aspirin 0 3 g oral,once daily and 75 mg oral at 3 days later,once daily;heparin 7 500 U subcutanous injection after thrombolysis therapy for 12 hours and once every 12 hours for 3 days;after therapy for 24 hours to judging the efficiency.Results:The total effective rate was 90 0% in 50 cases that were treated with UK intravenous thrombolysis;the total effective rates were 92 9% and 75 0% in 42 patients within 6 hours therapy and in 8 patients between 6 hours to 12 hours therapy respectively,there were no obvious difference between 2 groups ( u =1 55, P >0 05),but obvious difference in basic cured rate ( u =2 26, P <0 05).The total effective rate and basic cured rate in old patients (≥60 years old) were lower obviously than <60 years old patients ( u =2 01 and u =2 00,both P <0 05).The incidence of cerebral hemorrhage,cerebral edema and skin mucosae slight bleeding were 6 0%,6 0% and 4 0% respectively in patients that were treated with UK thrombolysis,they had no presented anaphylaxis,reinfarction and death.Conclusions:It indicate that UK treating ACI have a better efficiency,the disease course more short,patient′s age more young,the efficacy more favorable.

关 键 词：尿激酶 溶栓治疗 急性 脑梗塞 

分 类 号：R743.330.5[医药卫生—神经病学与精神病学]