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目的探讨阿替普酶(重组组织型纤维蛋白溶酶原激活剂,Rt-pa)与尿激酶(UK)静脉溶栓治疗急性脑梗死的临床效果。方法 120例经静脉溶栓治疗的急性脑梗死患者,按治疗方法不同分为Rt-pa治疗组和UK治疗组,各60例。对比观察两组患者经溶栓治疗后出血、脑梗死复发、死亡等情况。结果 Rt-pa治疗组出现出血患者11例,其中颅内出血4例,但未见症状性颅内出血;UK治疗组出现出血患者17例,其中颅内出血10例,症状性颅内出血3例;Rt-pa治疗组脑梗死复发8例,UK治疗组脑梗死复发12例;Rt-pa治疗组在治疗期间以及出院时的死亡患者5例,UK治疗组死亡患者7例;Rt-pa治疗组出院后的30 d内出现死亡患者1例,UK治疗组出现死亡患者3例;两组出血、脑梗死复发、死亡情况比较差异无统计学意义(P>0.05)。结论 Rt-pa与UK静脉溶栓治疗急性脑梗死的临床效果相当,且患者脑梗死出血、复发情况得到较好控制,死亡病例较少,均可用来治疗急性脑梗死。
Objective To investigate the clinical effect of intravenous thrombolytic therapy of alteplase (recombinant tissue plasminogen activator, Rt-pa) and urokinase (UK) in patients with acute cerebral infarction. Methods A total of 120 patients with acute cerebral infarction treated with intravenous thrombolysis were divided into Rt-pa treatment group and UK treatment group according to different treatment methods, 60 cases in each. Compare the two groups of patients after thrombolysis after bleeding, recurrent cerebral infarction, death and so on. Results There were 11 bleeding cases in Rt-pa group, including 4 cases of intracranial hemorrhage, but no symptoms of intracranial hemorrhage; 17 cases of bleeding in UK group, including 10 cases of intracranial hemorrhage and 3 cases of symptomatic intracranial hemorrhage; Rt- paw treatment group recurred in 8 cases of cerebral infarction, UK treatment group recurrent cerebral infarction in 12 cases; Rt-pa treatment group during treatment and discharge of patients in the death of 5 patients, UK treatment group died of 7 patients; Rt-pa treatment group after discharge 1 died in 30 days, and 3 died in UK treatment group. There was no significant difference between the two groups in the recurrence of hemorrhage and cerebral infarction (P> 0.05). Conclusion The clinical effect of intravenous thrombolytic therapy of Rt-pa and UK in treating acute cerebral infarction is quite similar. The hemorrhage and recurrence of cerebral infarction in patients with cerebral infarction are well controlled and the deaths are fewer, which can be used to treat acute cerebral infarction.