17例急性脑梗死尿激酶动脉溶栓治疗临床分析  

Clinical Efficacy of Intra-arterial Thrombolysis with Urokinase in Treating 17 Patients with Acute Cerebral Infarction

作　　者：潘海[1] 高飞[2] 佟志勇[3] 王运杰[3] 

机构地区：[1]沈阳医学院奉天医院神经外科,沈阳110034 [2]中国医科大学附属第四医院神经外科,沈阳110032 [3]中国医科大学附属第一医院神经外科,沈阳110001

出　　处：《中国医科大学学报》2010年第5期377-379,共3页Journal of China Medical University

基　　金：国家十一五科技支撑计划资助项目(2006BAIO1A12)

摘　　要：目的观察缺血性脑梗死急性期动脉溶栓治疗的临床疗效。方法应用尿激酶超早期动脉溶栓治疗急性脑梗死17例,于溶栓前及溶栓后24h、7d、1个月进行神经功能缺损评分,同时观察脑内及其他系统有无出血并发症,并观察肢体活动及意识改善情况。结果溶栓后24h瘫痪肢体肌力提高3级4例,2级7例,1级5例,无变化1例;1个月时,发病3h内溶栓组神经功能缺损欧洲脑卒中量表(ESS)分值升高更明显。本组有1例大面积脑梗死溶栓后出现非症状性出血性脑梗死,2例于溶栓结束后出现轻微齿龈出血,无1例死亡。结论尿激酶动脉溶栓治疗急性脑梗死其疗效较肯定,溶栓开始时间越早,疗效越好,在严格掌握适应证情况下应用比较安全。Objective To investigate the clinical efficacy of intra-arterial thrombolysis with urokinase in treating acute ischemic cerebral infarction. Methods A total of 17 patients with acute cerebral infarction were treated with urokinase in the early stage. The neurological impairment score before the treatment and 24 hours,7 days,and 1 month after the treatment were evaluated. We also observed the incidence of complications and the changes in limbs’activity and consciousness. Results After 24 hours of the treatment,the muscle strength increased by 3 grades in 4 patients,2 grades in 7,and 1 grade in 5. There was no change in the muscle strength in 1 patient. After 1 month of the treatment,the European Stroke Scale score was significantly higher in patients treated within 3 hours of onset than in other patients. Asymptomatic hemorrhagic transformation of cerebral infarction occurred in 1 patient and mild gingival bleeding in 2. None of the patients died. Conclusion Intra-arterial thrombolysis with urokinase is effective and safe in treating acute cerebral infarction. The earlier the treatment begins,the better the clinical efficacy is.

关 键 词：脑梗死 脑卒中 动脉溶栓 尿激酶 

分 类 号：R743.33[医药卫生—神经病学与精神病学]