CT血流灌注成像指导尿激酶静脉溶栓治疗急性脑梗死的临床分析

The Efficacy and Safety of UK Venous Thrombolysis Treatment in Acute Cerebral Infarction Patients.

目的:观察CT血流灌注成像指导尿激酶静脉溶栓治疗急性脑梗死的有效性和安全性。方法:30例符合《中国脑血管病治疗指南》静脉溶栓适应症的急性脑梗死患者,溶栓前行CT血流灌注成像检查,符合拟定的CT血流灌注成像溶栓指标的病例进行静脉溶栓治疗,治疗后观察6小时及21天神经功能缺损评分,溶栓24小时后及第7天复查头颅CT及凝血功能检查。结果:共25例符合拟定的CT血流灌注成像静脉溶栓指征的病例进行静脉溶栓治疗,治疗后6小时及21天基本治愈率达20%、52%,总有效率达84%、88%,无一例并发脑出血严重并发症,所有经CT血流灌注成像检查病人无一例出现对比剂过敏反应,凝血时间前后无明显变化。结论:CT血流灌注成像可以指导急性脑梗死的静脉溶栓治疗,疗效肯定且临床安全性较高。

Objective To assess the efficacy and safety of UK venous thrombolysis treatment under the supervision of CT perfusion in acute cerebral infarction patients. Methods According to the guidehne for ccrebrovascular disease prevention and treatment in China, 25 acute cerebral infarction patients who were suitable for venous thrombolysis were check with CT perfusion （CFP） before UK treatment. NIHSS was evaluated after 6 hours and 21 days of UK treatment, respectively. Cranial CT and prothrombin time were checked after 24 hours and 7 days of venous thrombolysis. Results A total of 25 patients were treated with UK. The cure rate after 6 hours and 21 days was 20% and 52%, respectively, total effective was 84% and 88%, respectively. No severe cranial hemorrhage, no allergic response to contrast agents occurred. There was no prothrombin time change after the treatment. Conclusions CIP can be applied for UK venous thrombolysis treatment in acute cerebral infarction with definite efficacy and safety.