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目的观察急性脑梗死患者进行超早期溶栓的临床疗效。方法选择急性脑梗死患者50例,根据治疗方法分为对照组和观察组各25例。对照组常规抗血小板、改善脑循环、营养脑神经细胞等药物治疗;观察组在常规治疗的基础上给予超早期溶栓治疗,溶栓药物选择尿激酶,药物总量50~150万U,先给予50万U加入0.9%氯化钠溶液100ml静脉滴注,15min滴完,如临床症状缓解不再增加尿激酶用量;如无改善则再给予50万U,30min滴完;如有改善不再增加尿激酶;如无改善则再给予50万U,60min滴完。溶栓后立即给予20%甘露醇125ml快速静脉滴注。2周后观察2组患者溶栓治疗血管再通情况、治疗前后NIHSS评分、临床疗效。结果观察组血管完全再通率44.0%明显高于对照组的20.0%(P<0.05);观察组总有效率为76.0%明显高于对照组的52.0%(P<0.05);2组NIHSS评分治疗后均较治疗前有改善,且治疗后观察组优于对照组,差异均有统计学意义(P<0.05)。结论急性脑梗死超早期溶栓治疗临床疗效优于传统常规用药,具有良好的效果,值得临床应用。
Objective To observe the clinical effect of ultra-early thrombolysis in patients with acute cerebral infarction. Methods Fifty patients with acute cerebral infarction were selected and divided into control group and observation group according to the treatment method. Control group conventional anti-platelet, improve cerebral circulation, nutrition, brain cells and other drugs; observation group on the basis of conventional treatment given ultra-early thrombolytic therapy, thrombolysis drug selection of urokinase, the total amount of drug 150 000 U, the first Given 500000 U adding 0.9% sodium chloride solution 100ml intravenous drip, 15min drip finished, such as clinical symptoms relieved no longer increase the amount of urokinase; if no improvement then give 500,000 U, 30min drip finished; if no improvement no longer Increase urokinase; If no improvement then give 500000 U, 60min drip finished. Thrombolytic immediately given 20% mannitol 125ml rapid intravenous infusion. Two weeks later, the thrombolysis recanalization in two groups was observed, NIHSS score and clinical effect before and after treatment. Results The total recanalization rate of the observation group was 44.0%, which was significantly higher than that of the control group (20.0%, P <0.05). The total effective rate was 76.0% in the observation group and 52.0% in the control group (P <0.05) After treatment than before treatment to improve, and after treatment, the observation group was better than the control group, the difference was statistically significant (P <0.05). Conclusion The clinical curative effect of ultra thrombolysis in acute cerebral infarction is better than that of traditional medicine, which has good effect and deserves clinical application.