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目的 评价应用尿激酶静脉内溶栓治疗急性脑梗死的有效性和安全性。方法 应用注射用国产尿激酶治疗急性脑梗死 16例 ,用法 :尿激酶 15 0万U溶入生理盐水 15 0ml内 ,30min滴完。分别在溶栓前、溶栓后 2h、2 4h、3d、7d、14d时间点 ,采用欧洲卒中量表 (ESS)对神经功能缺损进行评价。结果 75 %( 12例 )的患者ESS分值在溶栓后 2 4h内迅速增加。截止溶栓后 14d ,ESS分值仅有 1例无变化 ,2例下降。其中时间窗 <4h者ESS分值增加的速度明显高于 4～ 6h ,而后者又明显高于 >6h。本组非症状性脑内出血 2例 ( 12 .5 %) ,症状性脑内出血 1例 ( 6 .2 5 %) ;全身性出血 4例 ( 2 5 %) ;死亡率 1例 ( 6 .2 5 %) ,死因为脑内出血 ;再瘫痪 1例。结论 本研究提示尿激酶治疗急性脑梗死有效 ,如能严格掌握溶栓时间窗及适应症 ,可以提高治疗的安全性。
Objective To evaluate the efficacy and safety of intravenous thrombolysis with urokinase in the treatment of acute cerebral infarction. Methods 16 cases of acute cerebral infarction were treated with domestic urokinase for injection. Usage: 150,000 U of urokinase was dissolved in 15ml of normal saline and drip finished in 30 minutes. The neurological deficits were evaluated using the European Stroke Scale (ESS) before and at 2h, 24h, 3d, 7d and 14d after thrombolysis. Results The ESS scores of 75% (12 cases) patients increased rapidly within 24 h after thrombolysis. At the 14th day after thrombolytic therapy, only 1 patient had no change in ESS score and 2 patients had decreased. Which time window <4h ESS score increased significantly faster than 4 ~ 6h, while the latter was significantly higher than> 6h. The group of non-symptomatic intracerebral hemorrhage in 2 cases (12.5%), symptomatic intracerebral hemorrhage in 1 case (6.5%); systemic bleeding in 4 cases (25%); mortality in 1 case (6.55% %), Death due to intracerebral hemorrhage; paralysis and 1 case. Conclusion This study suggests that urokinase is effective in treating acute cerebral infarction. If we can master the thrombolytic time window and indications strictly, we can improve the safety of treatment.