颈内动脉注射尿激酶治疗静脉窦血栓临床疗效观察

Observation of Clinical Efficiency of the Treatment of Venous Sinus Thrombosis by Injection of Urokinase in Internal Carotid Artery

目的 :观察颈内动脉注射尿激酶治疗静脉窦血栓的临床疗效。方法 :9例脑静脉窦血栓形成患者予以左右颈动脉交替注射尿激酶 2 5万IU ,1日 1次 ,共 7次。同时监测凝血酶原时间、凝血酶原活动度和纤维蛋白降解产物。治疗后 7天 ,每日服用华法林钠片 2 5mg～ 5 0mg ,1日 1次 ,服用半年。结果 :7天后 ,8例患者头痛消失 ,视乳头水肿消失 ,脑脊液压力 0 97kPa～ 1 5 6kPa,3例DSA造影复查静脉窦再通 ,临床治愈 ,1例好转 ,8例DSA循环时间缩短为 1 5s～ 3 0s,无 1例出现局部血肿或全身出血。结论 :颈内动脉注射尿激酶治疗静脉窦血栓形成 ,效果显著 ,经济安全。

OBJECTIVE: To observe clinical efficiency of the treatment of venous si nus thrombosis by injection of urokinase in internal carotid artery .METHODS: 9 cases with cerebral venous sinus thrombosis were alternatively injected 250 0 00 IU urokinase in both left and right carotid arteries ,once per day, the tot al times were 7 . At the same time, prothrombin time , prothrombin activity and fibronectin degradation product were monitored. 7 days after treatment , 2 5 mg ～5 0 mg warfarin natricum tablets were taken everyday, once per day, the durat ion lasted half of a year .RESULTS:7 days later, headache and papilloedema in 8 cases disappeared , their cerebrospinal pressure was 0 97kPa～1 56kPa,DSA gra phs for reviewing clearance of venous sinus in 3 cases were found clinically cur e,1 case got better , circular time of DSA in 8 cases shortened to 1 5s～3 0s. No one occurred local hematoma or systemic hemorrhage. CONCLUSION: Injection of urokinase in internal carotid artery for venous sinus thrombosis has obvious effect and it is inexpensive and safe.