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目的探讨颈动脉内注射尿激酶治疗进展性脑梗死的临床疗效和治疗时机。方法 2004年1月～2005年6月住院病人60例随机分成 A 和 B 二组,记录治疗前,治疗后15 d,3月神经功能缺损评分,观察二组治愈率,显效率,有效率。结果治疗后15 d 神经功能缺损评分:A 组12.3±4.89,B 组15.23±3.01,t=2.50,P<0.05;治疗后3月神经功能缺损评分 A 组2.67±3.14,B 组6.67±3.18,t=5.78,P<0.001。3月临床疗效:治愈率 A 组50%,B 组13.3%,X~2=9.31,P<0.001;显效率A组93.3%,B 组56.67%,X~2=10.07,P<0.01。结论进展性脑梗死加重后3～24 h 颈动脉内多次注射尿激酶治疗,能迅速阻止病情的发展,改善预后,提高病人生存质量。
Objective To investigate the clinical efficacy and timing of carotid artery injection of urokinase in patients with advanced cerebral infarction. Methods From January 2004 to June 2005, 60 inpatients were randomly divided into two groups A and B. The scores of neurological deficits before and 15 days and 3 months after treatment were recorded. The cure rate, effective rate and effective rate of the two groups were observed. Results Neurological deficit scores on the 15th day after treatment were: 12.3 ± 4.89 in group A, 15.23 ± 3.01 in group B, t = 2.50, P <0.05; 3 months after treatment, neurological deficit score was 2.67 ± 3.14 in group A, 6.67 ± 3.18 in group B, t = 5.78, P <0.001. 3 months clinical curative effect: the cure rate of group A 50%, group b 13.3%, x 2 = 9.31, p <0.001; significant efficiency in group A 93.3%, group b 56.67% = 10.07, P <0.01. Conclusions Multiple injections of urokinase in the carotid artery 3 to 24 hours after progressive cerebral infarction aggravate can rapidly prevent the progression of the disease, improve the prognosis and improve the quality of life of patients.