经颅多普勒超声监护下超早期溶栓治疗脑梗死的研究

High rate of recanalization after unokinase infusion when continuously monitored with 2-MHz transcranial doppler monitoring

目的评价经颅多普勒超声(TCD)监护辅助尿激酶溶栓治疗脑梗死的有效性。方法26例急性脑梗死患者随机分为TCD辅助溶栓组和尿激酶对照组。TCD辅助溶栓组在尿激酶溶栓后2h内持续TCD监护。根据TCD血流速度及频谱形态判断血管再通情况,临床随访评定溶栓前后不同时间的NIH评分和Barthel指数。结果TCD辅助溶栓组血管再通率为76．9%明显高于对照组30．8%,溶栓后两组间NIH评分和Barthel指数评分存在显著差异。结论TCD有助于增强尿激酶的溶栓效果。

Objective To determine whether ultrasonagraphy can safely enhance the thrombolytic activity of unokinase. Methods 26 patients were randomly assigned to receive continuous ultrasonography（the target group） or placebo（the control group）. Residual flow signals were obtained from the clot location identified by TCD. National Institutes of Health Stroke Scale （NIHSS） and Barthel index were obtained before and after unokinase infusion. Results The percentage of reeanalization in the target group was76.9% ,significantly higher than that in the control group（30. 8% ）. NIHSS and Barthel index were significantly different after unokinase infusion between two groups. Conclusion TCD combined with unokinase is more effective than unokinase alone for acute cerebral infarctions.