超早期尿激酶静脉溶栓治疗急性脑栓塞的疗效观察

Observation of curative effects of ultra-early intravenous thrombolysis with urokinase on acute cerebral embolism

目的观察超早期尿激酶静脉溶栓治疗急性脑栓塞的疗效。方法对43例超早期急性脑栓塞患者(病程<3h)给予尿激酶70万～150万U加入生理盐水100ml静脉滴注溶栓治疗;在治疗前、后进行美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)及改良Rankin评分(mRS)评定;观察出血发生率。结果溶栓治疗后,NIHSS评分明显下降,BI、mRS上升(均P<0.05),总有效率为58.5%(25/43)。预后良好率为67.4%(29/43)。梗死灶内出血10例(23.3%),脑出血为1例(2.3%),无1例死于脑出血。结论超早期尿激酶静脉溶栓治疗急性脑栓塞有显著效果,并且比较安全。

Objective To observe the curative effects of ultra-early intravenous thrombolysis with urokinase on acute cerebral embolism. Methods 43 patients with acute cerebral embolism within 3 h since onset were given intravenous thrombolysis with 0.7～1.5 MU urokinase in 100 ml normal saline by intravenous drip. The scores of National Institutes of Health Stroke Scale （NIHSS）,Barthel Index （BI） and modified Rankin Scale （mRS） were detected before and after the treatment,and the incidence of bleeding was observed.Results After thrombolysis,the NIHSS scores were decreased,and BI,mRS scores were increased significantly （all P0.05）. The total effective rate was 58.5%（25/43）. The better prognosis rate was 67.4%（29/43）. 10 cases （23.3%） were found hemorrhage in infarction focus,and 1 case （2.3%） was found intracerebral hemorrhage. None of the 43 patients was died from substantial hemorrhage.Conclusion Ultra-early intravenous thrombolysis with urokinase is remarkably effective and relative safe on treatment for acute cerebral embolism.