摘要
目的 :探讨尿激酶颈动脉溶栓与静脉溶栓对发病 12小时内脑梗死患者的疗效。方法 :对 38例脑梗死患者应用尿激酶 (5 0～ 10 0 )× 10 4U颈动脉推注溶栓治疗 ,对 30例脑梗死患者应用尿激酶 (10 0～ 2 5 0 )× 10 4U静滴溶栓治疗。结果 :治疗 2小时颈动脉组 32例 (84.2 1% )有效 ,其中 7例 (18.42 % )治愈或基本治愈 ;静脉组2 5例 (83.33% )有效 ,无基本治愈病例 ;治疗 14日颈动脉组 35例 (92 .11% )有效 ,其中 2 4例 (6 3.16 % )治愈或基本治愈 ;静脉组 2 9例 (96 .6 7% )有效 ,其中 10例 (33.33% )治愈或基本治愈。颈动脉组 1例出现症状性脑出血 (2 .6 3% ) ,静脉组 5例有轻度全身性出血 (16 .6 7% )。结论 :发病 12小时内脑梗死患者尿激酶颈动脉溶栓与静脉溶栓疗效均较高 。
Objective:To evaluate the safety and efficacy of urokinase in carotid or venous thrombolysis in patients with acute ischemic stroke of anterior cerebral circulation,and to determine its impact on clinical outcome.Methods:38 patients(group A) were treated with carotid thrombolysis using urokinase 〔median dose,(50100)×10 4 U〕,and 30 patients (group B) with venous thrombolysis〔urokinase(100250)×10 4 U〕.The European Stroke Scale(ESS) score was assessed at hospital admission,second hour,second day,seventh day and fourteenth day after treatment.Results:After 2 hours of treatment,the use of urokinase proved to be effective in 32 patients (84 21%) in group A,of whom 7 cases (18 42%) met the criteria of clinical cure.The use of urokinase was effective in 25 ( 83 33%) patients in group B and no patients met the criteria of clinical cure.After 14 days of treatment,it proved to be effective in 35 patients (92 11%) in group A and 24 cases (63 16%) met the criteria of clinical cure in group A,whereas it was effective in 29 cases (96 67%) and 10 cases (33 33%) met the criteria of clinical cure in group B.Good outcome was associated with a better initial score and early treatment.Symptomatic cerebral hemorrhage occurred in 1 patient only (2 63%),who was treated with arterial thrombolysis,and mild systemic hemorrhage occurred in 5 patients (16 67%) in patients with venous thrombolysis.Conclusions:Carotid thrombolysis using urokinase is efficacious and relatively safe in patients with cerebral infarction when the initial neurological deficency score is not too bad and when treated within 12 hours.Carotid thrombolysis give a better result than venous thrombolysis.
出处
《中国危重病急救医学》
CAS
CSCD
2000年第5期287-289,共3页
Chinese Critical Care Medicine
关键词
脑梗死
溶栓治疗
颈动脉
静脉
尿激酶
acute cerebral infarction
carotid thrombolysis
vein thrombolysis
urokinase
