目的对比性探讨尿激酶超选择性动脉溶栓与静脉溶栓对发病 12小时内脑梗死患者的疗效。方法对 32例急性脑梗死患者应用尿激酶 2 0× 10 4U经股动脉行超选择性动脉灌注溶栓 ,对 36例急性脑梗死患者应用尿激酶 10× 10 4U静滴溶栓 ,每日 2次 ,10日为 1个疗程 ,并分别于治疗前及治疗后 1/ 2h、2h、2 4h、7d、14d行ESS评分。结果超选择性动脉溶栓组治疗后 1/ 2h、2h、2 4h的有效率及治疗后 1/ 2h、2h的ESS评分均明显优于静脉溶栓组 (P <0 .0 1) ,且治疗后 2 4h、7d、14d的治愈或基本治愈率均显著高于静脉溶栓组 (P <0 .0 1)。超选择性动脉溶栓组中 2例出现颅内出血 ,1例穿刺部位皮下血肿。静脉溶栓组中 4例有轻度全身性出血 ,1例颅内出血。结论尿激酶超选择性动脉溶栓与静脉溶栓均有较好的疗效与安全性 ,而超选择性动脉溶栓的早期疗效及治愈或基本治愈率均明显优于静脉溶栓组 Objective To compare the effects of urokinase super selective arterial thrombolysis and intravenous thrombolysis on patients with cerebral infarction within 12 hours after onset. Methods 32 cases of acute cerebral infarction patients with urokinase 20 × 104U via the femoral artery underwent superselective arterial infusion of thrombolytic therapy, 36 cases of acute cerebral infarction patients with urokinase 10 × 10 4U intravenous thrombolytic therapy, daily 2 Times, on the 10th for a course of treatment, and ESS score before treatment and after treatment 1 / 2h, 2h, 2 4h, 7d, 14d. Results The response rates of ESS at 1 / 2h, 2h and 24h after super selective arterial thrombolysis were significantly better than that of intravenous thrombolysis (P <0.01) at 1 / 2h and 2h after treatment The cure or basic cure rates at 24 h, 7 d and 14 d after treatment were significantly higher than those of intravenous thrombolysis group (P <0.01). Intracranial hemorrhage occurred in 2 cases in the super selective arterial thrombolysis group and in 1 case in the subcutaneous hematoma in the puncture site. Intravenous thrombolysis group, 4 patients had mild systemic bleeding, 1 case of intracranial hemorrhage. Conclusions Urokinase super selective arterial thrombolysis and intravenous thrombolysis have good curative effect and safety, while the super curative effect of early arterial thrombolysis and cure or basic curative rate are superior to intravenous thrombolysis group