应用循证医学观点对脑梗死急性期药物治疗的评价

Evaluation of the Efficacy of Drug Therapy for Acute Cerebral Infarction with Evidence Based Medicine Opinion

目的 :以循证医学观点对脑梗死急性期各种药物治疗的临床应用进行评价。方法 :采用国内外文献综述方法。结果与结论 :对于脑梗死急性期应用尿激酶、rtPA静脉溶栓、尿激酶原动脉溶栓、阿司匹林等均有效。肝素、低分子肝素抗凝治疗对心源性脑栓塞、凝血性疾病、症状性脑动脉狭窄、症状性颅外段夹层动脉瘤及静脉血栓形成有效。降纤酶、甘油、神经节苷脂和常规应用甘露醇等尚未得出结论。而血液稀释疗法、皮质类固醇激素。

OBJECTIVE: To evaluate the clinical efficacy of drug therapy for acute cerebral infarction with evidence based medicine opinion(EBM). METHODS:By reviewing literatures ab out this subject at home and abroad. RESULTS & CONCLUSION:Intravenous thromb olysis with urokinase or rtPA,intraarterial pro-urokinase thrombolysis and aspi rin were certainly effective in treatment of acute cerebral infarction. Anticoag ulation therapy with heparin or low molecular weight heparin was effective for c ardiogenic brain embolism,blood coagulation disorders,symptomatic cerebral art erial stenosis,symptomatic extracranial dissecting aneurysm and cerebral venous thrombosis. It has been a matter of dispute on the therapy efficacy of defibrac e,glyceryl,ganglioside and conventronal used mannitol when they were used in t reatment of acute cerebral infarction. However,negative results were obtained i n the therapy effect of hemodilution,corticosteriod,aminophylline and calcium antagonists on acute cerebral infarction.