基层医院急脑梗死尿激酶静脉溶栓治疗疗效观察

Observation of the clinical efficiency of urokinase intravenous thrombolytic therapyon acut cerebral infarction in primary hospital

目的 探讨急性脑梗死超早期尿激酶静脉溶栓治疗的疗效.方法 选取2015年1月至2017年1月本院收治的急性脑梗死（ACI）患者44例,随机分成观察组和对照组分成2组,每组22人,对照组予以阿司匹林预防在闭塞、尼莫地平保护脑细胞、依达拉奉清除过多氧自由基,观察组第一天予以尿激酶静脉溶栓治疗、尼莫地平保护脑细胞、依达拉奉清除过多氧自由基,24 h后观察组使用对照组相同的治疗方案.结果 在治疗后1 d观察组与对照组NIHSS评分比较,差异无显著统计学意义（P〉0.05）,但治疗后3、7、14 d,较治疗前两组 NIHSS 评分明显下降,观察组的 NIHSS 评分明显低于对照组,观察组总有效率90.90%,明显高于对照组的72.73%,差异具有统计学意义（P〈0.05）,在脏器出血方面两组无明显差异.结论 急性脑梗死实行超早期尿激酶静脉溶栓治疗疗效显著,可以明显改善患者神经功能缺失症状,安全性高,无需特殊设备,就能为基层医院用以紧急救治脑梗死患者,值得临床推广.

Objective To observe the clinical efficiency of urokinase intravenous thrombolytic therapy in ultra-early cerebral in-farction.Methods Forty-four patients with acute cerebral infarction （ACI）in our hospital from January 2015 to January 2017,were divided into observation group and control grouprandomly,22 patients in each group.The patients in control group were treated with aspirin to prevent re-occlusion,nimodipin to protect Neurone Cells,and edaravone to remove excessive oxygen free radicals;The patients in observation group in the first 24 hours were given urokinase intravenous thrombolytic therapy,and supplemented by nimodipin to protect Neurone Cells,edaravone to remove excessive oxygen free radicals,after the first 24 hours the observation group was given the same treatment as the control group.Results After the treatment 1d,there was no statistical significance by comparison to the NIHSS scores in observation group and control group（P〉0.05）,but after the treatment 3d,7d and 14d,com-pared with treatment before,the two groups′s NIHSS scores decreased obviously,the NIHSS scores of the observation group was significantly lower than that of the control group,The total effective rate of the observation group was 90.90%,which was signifi-cantly higher than that of the control group （72.73% ）,there was statistical significance between the observation group and The control group（P〈0.05）;the observation group than the control grouporgan hemorrhage had no obvious difference.Conclusion The intravenous thrombolytic therapy in ultra-early cerebral infarction had remarkable clinical curative effect,which Can significant-ly improve the neurological deficit symptoms,high safety,Without special equipment,which can be used for emergency treatment of patients with cerebral infarction in primary hospital,it is worthy of clinical promotion.