尿激酶静脉溶栓治疗缺血性脑卒中的成败分析

Analysis of the Urokinase Intravenous Thrombolysis in the Treatment of Ischemic Cerebral Stroke

目的探讨尿激酶用量、静脉溶栓时间窗、年龄及相关因素。方法将已确诊为缺血性脑卒中,用尿激酶静脉溶栓且资料完整的患者,分成成功组及失败组,对其溶栓前及溶栓后72h内的临床观察记录、凝血功能检查报告单、CT片报告单及溶栓前、后神经功能缺损程度评分记录等资料进行整理,并作对比性研究。分析时间窗、病例选择、尿激酶总量及单位时间用药剂量与病情转归的关系。结果(1)尿激酶总量及单位时间用药剂量与病情转归相关;(2)时间窗与病情转归相关;(3)患者的基本情况与病情转归相关。结论患者在满足:(1)病情基本情况允许、排出溶栓绝对禁忌证;(2)尿激酶首量50～100万单位、单位时间(每分钟)用药剂量1万单位左右;(3)时间窗在12h以内,使用尿激酶静脉溶栓治疗安全有效。

Objective To discuss the dosage of urokinase, the time window of intravenous thrombolysis, age and relevant factors. Methods The patients diagnosed as ischemic cerebral stroke, intravenous thrombolysis with urokinase were divided into successful group and defeat group.The data of clinical observation record,coagulation function check report, CT report and the scores of nerve function before thrombolysis and within 72 hours after thrombolysis were compared. The relationship between time window,choice of cases, total quantity of urokinase,the medication dosage at unit time and disease development was analyzed. Results The total quantity of urokinase, the medication dosage at unit time,time window and the basic condition of patients were related with disease development. Conclusion Under the condition （1）Basic condition is permited,without medication contraindication; （2）Urokinase first quantity 50-1000000 units,unit time dosage 10000 units; （3） Time window within 12 hours, urokinase thrombolysis is effective and safe.