急诊超早期尿激酶溶栓治疗急性脑梗死68例  

68 Cases of Emergent Thrombolytic Therapy with Urokinase for Acute Cerebral Infarction at Ultra-Early Stage

作　　者：简洪彬 徐爱云 黄国飞 毕尚青 伍嘉坚 

机构地区：[1]广东省新兴人民医院神经内科,新兴527400 [2]广东省新兴人民医院神经外科,新兴527400

出　　处：《中国药物评价》2012年第2期134-136,共3页Chinese Journal of Drug Evaluation

摘　　要：目的:探讨急诊超早期尿激酶溶栓治疗急性脑梗死的临床疗效。方法:将入组病例随机分为观察组和对照组。两组常规基础性综合治疗相同;观察组在常规基础治疗基础上予以尿激酶静脉推注;溶栓后予以20%甘露醇静脉滴注,并予低分子右旋糖酐静滴,同时常规服肠溶阿司匹林;并予低分子肝素脐周皮下注射。对照组仅在常规基础性治疗基础上予静脉滴注低分子右旋糖酐、低分子肝素、肠溶阿司匹林。两组患者疗程均为14d。结果:观察组总有效率82.35%,对照组总有效率63.24%,两组比较差异均有统计学意义(P<0.01);溶栓后2h与治疗前比较两组均有不同程度的减少,且观察组效果更为明显,与治疗前比较,差异有统计学意义(P<0.01);两组治疗后评分与治疗前比较均有显著性差异(P<0.05,P<0.01),组间评分比较差异亦有显著性(P<0.01)。结论:严格掌握溶栓治疗适应证,急诊超早期应用尿激酶经静脉治疗急性脑梗死,能够提高临床疗效,减轻残障程度。Objective： To Investigate the clinical effects of emergent thrombolytic therapy with urokinase for acute cerebral in- farction at ultra-early stage. Methods： All patients were randomly divided into observation group and control group. Conventional basic comprehensive treatment of both groups are the same. Intravenous bolus of urokinase were added on the basis of conventional basic treatment in the observation group. Intravenous infusion of 20% mannitol and dextran were used after thrombolysis, while enter- ic-coated aspirin being taken orally at the same time. And subcutaneous injection of low molecular heparin was taken periumbili- cal. Intravenous infusion of dextran, subcutaneous injection of low molecular heparin and oral using of enteric-coated aspirin were added on the basis of conventional basic treatment in the control group. The treatment of both group lasted 14 d. Results： The effec- tive rate of the observation group was 82. 35%, being significantly higher than that of the control group（ 63.24% ）. Statistical differ- ences were found between the two groups （P 〈 0. 01% ）. The effective rates of the two groups had different levels of reduction 2 h af- ter thrombolysis,comparing with that before treatment. The difference was statistically significant （P 〈 0. 01% ）. The scores in both groups after treatment were significantly different from those before treatment （ P 〈 0. 05, P 〈 0. 01 ）. Statistical differences of the scores were showed between the two groups （ P 〈 0. 01% ）. Conclusion： We should strictly control the indications of thrombolytic therapy. Emergent thrombolytic therapy with urokinase for acute cerebral infarction at ultra-early stage can improve clinical outcomes and reduce the degree of disability.

关 键 词：急性脑梗死 溶栓 尿激酶 超早期 

分 类 号：R743.3[医药卫生—神经病学与精神病学]