超早期急诊尿激酶溶栓治疗急性脑梗死的临床疗效分析

Clinical efficacy of ultra early thrombolysis of urokinase on acute cerebral infarction

目的探讨超早期急诊尿激酶溶栓治疗急性脑梗死的临床疗效和安全性。方法将我院急诊科收治的急性脑梗死182例患者随机分为溶栓治疗组和对照组,在给予抗血小板聚集、降低颅内压、促进脑功能恢复的基础上,对照组给予静脉滴注低分子肝素钠,治疗组给予尿激酶溶栓治疗,比较两组的神经功能缺损(NIHSS)评分和评价日常生活活动能力的Barthel指数(BI)。结果治疗前两组的NIHSS评分和BI没有显著性差异(P>0.05),经过2个疗程治疗后,溶栓治疗组的总有效率为91.3%,显著高于对照组的57.8%,NIHSS评分和BI显著优于对照组(P<0.05),且超早期的溶栓治疗可以显著提高血管再通率(P<0.05),两组不良反应发生率没有显著性差异。结论超早期急诊尿激酶溶栓治疗急性脑梗死具有较好的临床疗效,可改善患者的临床症状和预后,提高生活质量,安全性好,值得临床推广使用。

Objective To explore the clinical effects and safety of ultra early thrombolysis of urokinase treatment on a- cute cerebral infarction （ACI）. Methods The 182 qualified patients of ACI were divided as therapy group and control group randomly. On the basis of treatment including anti-piatelet aggregation, reducing intracranial pressure and brain function improvement, the patients of control group were treated with low molecular heparin through intravenous drip, the patients of therapy group were given thrombolysis of urokinase treatment. The National Institute of Health Stroke Scale （NIHSS） score and Barthel index （BI） were used to evaluate and compare the neurological function and activities of daily living, respectively. Results No significant differences of NIHSS score and BI were observed between the ther- apy group and control group before the treatment （P 〉 0.05）. After treatment, the total effective rate, NIHSS score and BI of therapy group were significantly superior to the control group （P 〈 0.05）. Besides, the ultra early thrombolysis of uroki- nase treatment could improve the reopen rate of blood vessel obviously （P 〈0.05）. There was no significant difference of adverse reaction rate between the two groups （P 〉 0.05）. Conclusion The ultra early thrombolysis of urokinase treatment can improve the clinical symptoms, prognosis and life quality of acute cerebral infarction patients and it＇s worthy to be widely spread in clinical condition.