急性脑梗死早期尿激酶静脉溶栓的治疗体会

Treatment experiences of early intravenous thrombolysis with urokinase in acute cerebral infarction

目的:观察早期用尿激酶静脉溶栓治疗急性脑梗死的疗效及安全性。方法:7例急性脑梗死患者早期应用尿激酶进行溶栓治疗,记录患者溶栓前与溶栓后24 h神经功能缺失评分、出院时格拉斯哥预后评分(glasgow outcome score,GOS)和影像学改变。结果:溶栓前后24 h 3例评分降低≥10分,3例患者评分降低>5分而<10分,1例降低<5分。3例患者出院时GOS评分为5分,2例4分,1例3分,1例1分。结论:急性脑梗死早期应用尿激酶静脉溶栓治疗是提高患者生存质量有效的方法之一,但需严格把握溶栓时间窗、适应证与禁忌症。

Objective：To evaluate the efficacy and safety of intravenous thrombolysis with urokinase at the early stage of acute cerebral infarction . Methods：Seven patients underwent intravenous thrombolysis with uroki-nase at the early stage of acute cerebral infarction , and the neurological impairment scores were maintained before and 24 h after thrombolysis. Glasgow Outcome Score（ GOS） were used on discharge to evaluate the de-gree of patient′s recovery in terms of neuroimaging changes.Results：Quantitative measurement on the National Institutes of Health Stroke Score （ NIHSS） rating basis showed that 3 patients scored lower than or equal to 10,another 3 were between 5 and 10 and 1 was under 5 after 24 h of thrombolysis.GOS rating demonstrated that 3 patients were in level 5 and 2 in level 4,and 1 patient was in level 3 and another 1 in level 1.Conclu-sion：Intravenous thrombolysis with urokinase in acute cerebral infarction at the early stage of attack appears effective to improve the quality of life of patients,yet the time window for treatment,indications and contraindi-cations should be strictly determined .