颈内动脉内注射尿激酶治疗10例急性脑梗死的临床应用研究

The clinical study of urokinase injected into internal carotid in treating 10 cases of acute cerebral infarction patients

目的 探讨颈内动脉注射尿激酶治疗急性脑梗死的临床效果 ;探讨尿激酶应用对病人凝血功能的影响 ;探讨术前准备、术中管理的作用。方法 利用 Seldinger技术经股动脉插入 5 F血管鞘 ,引入 5 F单弯导管接近阻塞动脉处应用尿激酶 5 0～ 10 0万 u+生理盐水 30 0～ 5 0 0 ml,加压注入 ,每次 10～ 2 0 ml,30～ 4 0 min内注完。治疗前后检测凝血功能 ;根据疗效标准评价溶栓治疗效果 ;严密观察溶栓副作用。结果 临床有效率为 10 0 % ;尿激酶应用前后 ,凝血功能有明显变化 ;10例临床未发现过敏及出血副作用 ;严格掌握治疗时间窗、充分的术前准备和严格术中管理是溶栓成功的关键。结论 尿激酶只是一种相对安全的溶栓剂 。

Objective To study the clinical effect of urokinase injected into internal carotid in treating acute cerebral infarction patients,investigate the influence of coagulation function of urokinase and discuss the importance of preparation before and management in operation.Methods Using Seldinger's technique,we inserted 5F conductor through the femoral artery.The single curved pipe was led close to the block arteria and urokinase(500 000～1 000 000 u+0.9%ND 300～500 ml)was infused,10～20 ml per time within 30～40 min.Before and after treatment,we measured coagulation function of patients.Results The clinical effective rate was 100%(10/10).After application of urokinase,the patients' coagulation function has changed remarkably.No allergy and hemorrhage side effect were found in 10 clinical cases.Strict grasping of treat-time window,sufficient preparation before operation and management in operation are the crux of the matter.Conclusion Urokinase is only a relatively safe medicine.Injecting urokinase into internal carotid is one of effective methods in treating acute cerebral infarction.