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目的观察大剂量尿激酶治疗脑梗死超早期的静脉溶栓效果。方法对40例符合溶栓条件的急性脑梗死病人在发病6h内给予尿激酶100万U静滴,辅以低分子右旋糖酐500m l/d,内加脉络宁针20m l,连用15d,溶栓有效者,次日起给予低分子肝素2500U,B id,iH连用5~7d。对照组不用尿激酶,只用低分子右旋糖酐、脉络宁及低分子肝素等药物,用法及用量同溶栓组,适当给予甘露醇脱水降颅压治疗。结果溶栓治疗40例,第21d基本痊愈12例,占30.0%,显著进步21例,占52.5%,总显效率为82.5%(33/40)。对照组42例,基本痊愈10例,显著进步10例,各占23.8%,总显效率为47.6%。两组间比较差异有统计学意义(P<0.05),溶栓组出血率为10%(4/40),脑内出血占5%(2/40),对照组出血率为5%(2/40),全为颅内出血。结论大剂量尿激酶超早期(6h以内)静脉溶栓治疗急性脑梗死有效。
Objective To observe the ultra-early intravenous thrombolytic effect of high-dose urokinase for cerebral infarction. Methods Forty patients with acute cerebral infarction who were eligible for thrombolysis were treated with intravenous infusion of 1 million UU of urokinase within 6 hours of onset, supplemented with low molecular dextran 500 ml / d and internal fixation with Mailuoning injection 20 ml for 15 days. Thrombolysis was effective The next day given low molecular weight heparin 2500U, B id, iH use 5 ~ 7d. Control group without urokinase, only low molecular weight dextran, Mailuoning and low molecular weight heparin and other drugs, usage and dosage with the thrombolytic group, appropriate mannitol dehydration and intracranial pressure treatment. Results Thrombolytic therapy in 40 cases, 21 days basically cured in 12 cases, accounting for 30.0%, significantly improved in 21 cases, accounting for 52.5%, the total effective rate was 82.5% (33/40). The control group of 42 cases, basically cured in 10 cases, significantly improved in 10 cases, each accounting for 23.8%, the total effective rate was 47.6%. Bleeding rate was 10% (4/40) in thrombolytic group, 5% (2/40) in intracerebral hemorrhage, and 5% in control group (2/40). There was significant difference between the two groups (P <0.05) 40), all for intracranial hemorrhage. Conclusion High-dose of urokinase ultra-early (within 6h) intravenous thrombolytic therapy of acute cerebral infarction.