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目的:研究尿激酶静脉滴注溶栓联合低分子量肝素钙皮下注射治疗超急期脑梗死的疗效与安全性;观察治疗时间窗对疗效与出血性事件发生率的影响。方法:以24例发病12小时以内的脑梗死为静脉溶栓治疗组,并与具有可比性的20例常规治疗对照组作对照研究。治疗组给予低分子量肝素0.4mL,皮下注射,每日3次,持续10日,第一日给予尿激酶150万单位至200万单位,静脉滴注,其余治疗与对照组基本相同。结果:溶栓治疗组治愈率67%16/24,总有效率88%21/24,明显高于对照组。治疗组住院时间11±4日、对照组21±5日P<0.05。治疗组出血性事件发生率25%6/24,对照组10%。治疗组6小时以内治疗的病人的治愈率明显高于6小时至12小时内治疗者,而出血发生率则相反。结论:低分子量肝素与尿激酶联合静脉溶栓治疗急性脑梗死有肯定疗效。溶栓治疗的时间窗宜为发病后6小时以内。
Objective: To study the efficacy and safety of intravenous infusion of urokinase combined with subcutaneous injection of low molecular weight heparin calcium for the treatment of hyperacute cerebral infarction. To observe the effect of treatment time window on the incidence of hemorrhagic events. Methods: Twenty-four patients with cerebral infarction within 12 hours after onset were treated with intravenous thrombolysis and compared with 20 routinely-treated control groups with comparability. The treatment group was given low molecular weight heparin 0.4mL, subcutaneous injection 3 times a day for 10 days, the first day of 1.5 million units of urokinase to 2 million units, intravenous infusion, the rest of the treatment and control group basically the same. Results: The cure rate of thrombolysis group was 67% 16/24, the total effective rate was 88% 21/24, which was significantly higher than that of control group. Treatment group hospitalized for 11 ± 4 days, control group 21 ± 5 days P <0.05. The incidence of hemorrhagic events in the treatment group was 25% 6/24 and in the control group 10%. In the treatment group, the cure rate of patients treated within 6 hours was significantly higher than that of the treatment group within 6 hours to 12 hours, while the bleeding rate was the opposite. Conclusion: Low molecular weight heparin and urokinase combined with intravenous thrombolysis in the treatment of acute cerebral infarction have a positive effect. Thrombolytic treatment time window should be less than 6 hours after onset.