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本文报导四例急性缺血性半球卒中病人在应用尿激酶治疗过程中发生脑出血的临床及病理。例1:66岁,女,左手左脚间歇发作刺痛已六个月,入院当日晨起床时发现说话及左侧肢体活动困难。入院时血压210/95毫米汞柱,神清,构音差,典型左侧三偏征。腰穿,实验室检查均正常。治疗前血浆纤维蛋白元240mg%,一期凝血酶元时间14.4秒,凝血酶凝固时间10.1秒,血浆再钙化时间62秒,优蛋白凝块溶解时间大于4小时。于下午1时15分开始静脉输注尿激酶,剂量为每磅每小时1500单位,8小时总量220万单位。7小时后病人突然呕吐,昏迷,陈——斯氏呼吸,瞳孔缩小,立即停药。治疗后的凝血象与治疗前者无明显改变。血管造影发现右颈内动脉分叉处狭窄,床突以上闭塞,右大脑前动脉未允盈,中动脉枝稍充盈。病人于数小时后死亡。神经病理:脑肿胀,脑干向左偏移,右颈内动脉广泛性粥样硬化,右中动脉及前动脉管壁增厚,
This article reports the clinical and pathological findings of four cases of cerebral hemorrhage in patients with acute ischemic hemisphere stroke treated with urokinase. Example 1: 66-year-old woman, left hand, left leg intermittent sting has been six months, get up on the morning of admission found talking and left limb activity difficulties. Admission of blood pressure 210/95 mm Hg, Shen Qing, poor articulation, the typical left three levy. Waist wear, laboratory tests are normal. Pretreatment plasma fibrinogen 240mg%, a period of thrombin time 14.4 seconds, thrombin coagulation time 10.1 seconds, plasma recalcification time 62 seconds, optimal protein clot lysis time greater than 4 hours. At 1.15 pm, intravenous infusion of urokinase was started at a dose of 1500 units per pound per hour and a total of 2.2 million units in 8 hours. 7 hours after the patient suddenly vomit, coma, Chen - Smith’s breath, miosis, immediate withdrawal. After treatment of coagulation and treatment of the former no significant change. Angiography found that the right internal carotid artery bifurcation stenosis, occlusion above the bed, the right anterior cerebral artery did not allow surplus, aortic filling slightly. The patient died after a few hours. Neuropathology: Brain swelling, left shift of brain stem, extensive atherosclerotic plaque of the right internal carotid artery, thickened wall of the right middle and anterior arteries,