颈动脉注射尿激酶治疗颈动脉系统脑梗死的临床研究

THE RESEARCH OF CAROTID ARTERY INJECTION OF UROKINASE IN THE CLINICAL TREATRMENT FOR CAROTID SYSTEM CEREBRAL INFARCTION

目的：探讨尿激酶经颈动脉直接注射溶栓与大剂量尿激静脉溶栓的疗效以及副作用等方面的比较。方法：将入选的66例脑梗死随机分成两组，一组为经颈动脉注射尿激酶组32例，采用直接经颈动脉注射经生理盐水20mL＋尿激酶50万U后，再经静脉滴注NS2100mL＋尿激酶50万U；对照组为静脉溶栓组共34例，采用尿激酶100-150万U＋NS100mL在30min内静脉滴注完毕。两组的其他常规治疗相同。14d后观察疗效和不良反应。结果：A组：基本治愈12例（37．5％），显著进步14例（43．8％），显效率为96．9％；而V组基本治愈8例（23．5％），显著进步9例（26．5％），显效率为85．3％。结论：颈动脉注射联合静脉应用尿激酶治疗脑梗死的疗效显著高于静脉滴注的疗效（P〈0．01）。

Objective：To compare the efficacy and side effects of direct carotid artery injection thrombolytic therapy of urokinase with high -dose intravenous thrombolysis. Methods：66 cases of cerebral infarction patients were randomLy divided into two groups. 32 cases in the carotid artery injection of urokinase group was treated with direct carotid artery injection of saline 20mL ＋ 500,000U of u- rokinase,and then treated by intravenous drip NS100mL ＋ Urokinase 500,000U; 34 cases in the intravenous thrombolysis group was treated by 1,000,000 - 1,500,000 U of urokinase ＋ NS100mL within 30 minutes intravenous drip. Both two groups were treated by the same other conventional therapy. The efficacy and adverse reactions were observed for 14 days after the injection. Results：Group A： 12 cases cured （37.5%） ,14 cases gained significant progress （43.8%） ,markedly effective rate was 96. 9% ;and in group V 8 cases healed （23.5%）, 9 cases gained significant progress （26. 5% ）, remarkable efficiency of 85.3%. Conclusion： Carotid artery injec- tion venous urokinase in treating cerebral infarction was significantly higher than the efficacy of intravenous （ P 〈 0. 01 ）.