急诊尿激酶静脉溶栓治疗超早期脑梗死临床观察  

Clinical research in the effects of urokinase on acute cerebral infarction in very early stage

作　　者：顾彬[1] 张劲松[2] 赵高年[3] 

机构地区：[1]泰州市人民医院急诊医学科,江苏省泰州225300 [2]南京医科大学第一附属医院急诊科 [3]泰州市人民医院神经内科,江苏省泰州225300

出　　处：《中华急诊医学杂志》2010年第9期957-959,共3页Chinese Journal of Emergency Medicine

基　　金：江苏省科技支撑计划-社会发展（BE2009611）

摘　　要：目的 比较急诊溶栓与住院溶栓治疗急性脑梗死患者的疗效,以探讨缩短患者院内延迟时间对超早期脑梗死患者是否带来更多获益.方法 发病距就诊时间小于3 h,在急诊接受溶栓治疗者作为研究组,同期神经内科病房溶栓病例作为对照组.结果 急诊溶栓组患者来诊至溶栓治疗开始的平均时间为45 min,发病3 h内接受溶栓治疗者39例（14.4%）;住院溶栓组来诊至溶栓治疗开始的平均时间为80 min,发病3 h内接受溶栓治疗者29例（10.5%）.两组治疗后NIHSS评分比较差异具有统计学意义;bathel指数完全恢复和基本完全恢复率,差异有统计学意义.结论 急诊尿激酶静脉溶栓治疗超早期脑梗死可缩短院内延迟时间,使更多的患者能够得到溶栓治疗,从而减轻神经功能缺损程度,改善患者预后.Objective To study the effects of thrombolysis for the treatment of acute cerebral infarction （ACI） in early stage （within 6 hours after onset） in hospital, and to demonstrate the benefit of urokinase in the treatment of acute cerebral infarction. Method The patients with cerebral infarction treated with UK within 3hours after onset in the emergency department were enrolled as the study group, and those treated with thrombolytics in the neurological unit over the same period were taken as the control group. Results The average time from onset of ACI to starting thrombolytic therapy was 45 minutes in the study group and 80 minutes in the control group.The number of patients treated with thrombolysis within 3 hours was 39 （ 14.4% ） in the study group and 29 （10.5%） in the control group. There were significant differences in the scores of the National Institutes of Health Stroke Scale （NIHSS） after thrombolytic therapy and in Bathel index of complete or nearly complete recovery rate between two groups. The length of hospital stay was shorter in patients of the study group than that in the control group. Conclusions The thrombolytic treatment with urokinase employed to the patients in the early stage of acute cerebral infarction leads to better outcomes than that in the later stage.

关 键 词：急诊 静脉溶栓 脑梗死 尿激酶 

分 类 号：R743.3[医药卫生—神经病学与精神病学]