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目的对心源性脑卒中急性期静脉抗栓治疗进行一些探讨。方法回顾性分析30例心源性脑卒中急性期患者的病变及尿激酶静脉抗栓的效果。结果 24h内显著改善8例(26.7%),NIHSS评分抗栓前为10～15分,抗栓24h后为6～11分。有效14(46.7%),NIHSS评分抗栓前为12～16分,抗栓24h后为10～14分。无变化3例,NIHSS评分抗栓前为15～17分,抗栓24h后基本无变化。5例抗栓前评分为18～20分,抗栓后2h病情进行性加重,复查头颅CT显示左侧大脑中动脉供血区大面积梗死,内有出血,抗栓12h后发生脑疝。结论 NIHSS评分越低抗栓效果越佳,发生出血的风险也越小。
Objective To study the acute intravenous antithrombotic therapy of cardioembolic stroke. Methods A retrospective analysis of 30 patients with acute stroke in patients with acute heart disease and urokinase intravenous antithrombotic effect. Results Significant improvement in 24h within 8 cases (26.7%), NIHSS score before antithrombotic 10 ~ 15 points, 24h after antithrombotic 6 ~ 11 points. Effective 14 (46.7%), NIHSS score 12-16 before antithrombotic, antithrombotic 24h after 10-14. No change in 3 cases, NIHSS score 15 to 17 points before antithrombotic, antithrombotic basically unchanged after 24h. 5 cases of antithrombotic score of 18 to 20 points, 2h after antithrombotic progressive aggravated, review of the cranial CT showed a large area of the left middle cerebral artery infarction, with bleeding, 12h after antithrombotic herniation. Conclusion The lower the NIHSS score, the better the antithrombotic effect and the lower the risk of bleeding.