尿激酶静脉溶栓治疗急性脑梗死并发脑出血分析

An Analysis on Complication of Cerebral Hemonrrhage during the Treatment of Acute Cerebral Infarction by Urokinase

目的 :探讨尿激酶治疗急性脑梗死并发脑出血的发生率和原因。方法 :78例入选的急性脑梗死患者 ,应用尿激酶治疗 ,于 2 4h内复查头颅CT或MRI,溶栓前后按欧洲脑卒中神经功能缺损评分标准评分。结果 :尿激酶静脉溶栓治疗急性脑梗死的主要并发症是脑出血 ,且几乎发生于溶栓后 2 4h内 ,其原因与栓子溶解后血液渗出 ,继发性纤溶亢进 ,凝血功能障碍 ,血管再通后灌注损伤等有关。另外动脉内溶栓可能是降低颅内出血发生率的有效方法。结论 :尿激酶静脉溶栓治疗脑梗死是有效的 ,但可导致脑出血。

Objective: To investigate the incidence and relative factors of cerebral hemorrhage during thrombolytic therapy on acute cerebral infarction(ACI) by Urokinase(UK). Methods: 78 patients diagnosed as ACI were selected and treated with urokinase through intraveneous drip and were reexamed with CT or MRI within 24 hours.The clinical nerous function and defect degree were judged before and after treratment according to the European Stroke Scale(ESS)standards. Resuits: 15 patients had complication of cerebral hemorrhage (accounted for 20 5%).One of them died from this complication (accounted for 11 5%). Almost all the cases of the complication happened within 24 hours. Conclusion: The main complication of thrombolytic therapy in ACI is corebral hemorrhgae caused by excissively low fibrinogen, secondary hyperfibrinolysis, disability of clothing function and cerebral ischemia reperfusion injury existed. Perhaps an effective way through thrombolysis in arteries could be adopted to reduce the incidence of cerebral hemrrhage