【摘要】 目的观察脑梗死超早期尿激酶溶栓治疗效果并探讨其临床意义。方法选取2011年6月~2013年2月新昌人民医院收治的急性脑梗死(ACI)患者62例,根据治疗方法分为观察组与对照组各31例。观察组依患者体重差异选择(100~150)万U的尿激酶进行溶栓治疗,辅以尼莫地平保护脑神经、甘露醇清除过多氧自由基、低分子肝素钠及阿司匹林预防再闭塞;对照组除未用尿激酶外,其余皆与观察组相同。结果观察组治疗后1d、2d、7d NIHSS评分均明显低于治疗前,对照组患者治疗后2d、7d NIHSS评分均明显低于治疗前,差异均具有统计学意义(P<0.05)。治疗前及治疗后2h观察组与对照组NIHSS评分比较,差异无统计学意义(P>0.05);治疗后1d、2d、7d观察组NIHSS评分分别为(8.8±2.9)分、(7.4±3.1)分、(5.1±2.2)分,均明显低于对照组的(10.7±3.5)分、(10.3±2.8)分、(9.2±3.0)分,差异均具有统计学意义(P<0.05);治疗后观察组总有效率为80.6%,对照组总有效率为67.7%,两组比较,差异具有统计学意义(P<0.05)。结论只要严格掌握脑梗死超早期尿激酶静脉溶栓的适应证与禁忌证,无需特殊设备,就能为基层医院所用以紧急救治脑梗死患者。更多还原

【Abstract】 Objective To observe the efficiency of urokinase thrombolytic therapy in ultra-early cerebral infarction and explore its clinical significance. Methods Sixty-two patients with acute cerebral infarction(ACI) received in Xinchang people’s hospital from Jun., 2011 to Feb., 2013 were divided into observation group and control group according to a prospective randomized open method, 31 cases in each group. The patients in observation group were given thrombolytic therapy with 1~1.5 million U urokinase according to different body weights, and supplemented by nimodipine to protect the cranial?nerves, mannitol to remove excessive oxygen free radicals, low molecular weight heparin and aspirin to prevent re-occlusion. The treatment method in control group was the same as observation group except for urokinase. Results NIHSS scores 1d, 2d and 7d after treatment in observation group as well as 2 d and 7d after treatment in control group were decreased obviously compared with treatment before, with significant differences(P < 0.05) Before and 2h after treatment, there was no statistical significance by comparison to the NIHSS scores in observation group and control group(P > 0.05). 1d, 2d and 7d after treatment, NIHSS scores in observation group(8.8±2.9),(7.4±3.1) and(5.1±2.2) points were significantly lower than those in control group(10.7 ±3.5),(10.3± 2.8) and(9.2 ± 3.0) points, the differences were statistically significant(P < 0.05). After treatment, the total effective rates in observation group and in control group were 80.6% and 67.7%, respectively, and the difference was statistically significant(P < 0.05). Conclusion Only when indications and contraindications of urokinase thrombolytic therapy in ultra-early cerebral infarction are mastered strictly can the patients with cerebral infarction be given emergency aid and treatment in primary hospitals without special equipments.更多还原