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1、经颅超声溶栓治疗超早期急性脑梗死的临床研究杜敢琴黄丽娜戚继胜高秀兰富奇志刚光霞郎鸿志河南科技大学第一附属医院神经内科洛阳471003［摘耍］冃的评价经颅超声溶栓治疗超早期急性脑梗死的临床疗效。方法急性脑梗死患者80例，均为发病6h内就诊者。同意溶栓治疗的患者66例随机分为3组：尿激酶（UK）溶栓组、经颅超声溶栓组、经颅超声加尿激酶溶栓组，每组22例。不同意溶栓治疗的患者14例作为对照组，只接受对症治疗。尿激酶100万U溶于生理盐水100ml静脉滴注，半小时内滴完。应用经颅超声溶栓治疗仪（频率:800k
2、Hz,0.75W/cm2,脉冲超声）治疗，每天一次，每次20min,共10天。对各组治疗前后的神经功能缺损、日常生活能力及凝血功能进行分析比较。结果治疗后3个月，按欧洲卒中评分标准评分，经颅超声加尿激酶治疗组得分最高（95.33土3.37）,对照组最低（79.17±8.73）,即经颅超声加尿激酶治疗对恢复神经功能缺损的效果最显著；按Barthel指数评分，轻度残疾或无残疾的比例最高（85.71%）,对照组最低（41.67%）。对凝血功能无影响。未见不良反应。结论经颅超声有溶栓作用，并可增强尿激酶的溶栓
3、效果，能促使神经功能恢复；因此，经颅超声溶栓治疗急性脑梗死是一种安全、有效、操作简单的治疗方法。［关键词｝经颅超声溶栓；尿激酶；脑梗死ClinicalStudyonTranseranialUltrasoundThrombolysisinTreatmentforVeryEarlyStagePatientswithAcuteCerebralInfarctionDuGan-qin,HUANGLi-na,QIJi-sheng,GAOXiu-lan,FUQi-zhi,GANGGuan-xia,LANGHong-
4、zhiDepartmentofNeurology,TheFirstAffiliatedHospital,HenanUniversityofScieneeandTechnology,471003Louyang,China[Abstract]ObjectiveTostudytheclinicaloutcomeoftranscranialultrasoundthrombolysisinthetreatmentforveryearlystagepatientswithacutecerebralinfareti
5、on.MethodsEightypatientswithacutecerebralinfarctionwithin6hoursoftheonsetofstrokewereenrolledinthetrial.WritteninformedconsentforparticipationinthetrialwasprovidedbyallpatientsbutthecontroloSixty-sixpatientswererandomizedlydividedintothreegroups:urokina
6、sethrombolysisgroup,transcranialultrasoundthrombolysisgroupandtranscranialultrasoundplusurokinasethrombolysisgroup,inwhich22caseseachineluded；andthecontrolgroupineluded14patientsreceivedsymptomatictherapyalone.Adoseofurokinase100MUdissolvedinnormalsalin
7、e100mlwasgivenbyintravenouseinfusionwithin30min.Ultrasound(800kHz,0.75W/cm2,pulsewave)wasgivenonceadayfor10days..Neurogicaldeficit,capacityoflifeandcoagulationfunctionweredeterminedbeforeandaftertreatmentandat3months,andthenperformedstatisticalanalysis.
8、ResultsThreemonthsaftertreatmentthesymptomimprovementscoreintranscranialultrasoundplusurokinasegroupwasthehighest(95.33±3.37),whilethatincontrolgroupwasthelowest(79.17±8.73)onthescoreoftheEuropeanStrokeScale,Thatmeanstheimproveme
