CAJ | 학술논문

目的：探讨急性脑梗死尿激酶溶栓术后早期抗凝治疗的安全性和有效性。方法选择急性脑梗死予动脉溶栓患者117例,随机分为治疗组与对照组,治疗组在溶栓术后6小时予低分子肝素钙5000 IU 皮下注射2次/d,2周为1疗程；对照组在溶栓术后24小时予以抗凝治疗。两组降压、降糖、强化降脂、神经保护、防治并发症等基础治疗相同,监测活化凝血酶原时间(ACT)值。依据美国国立卫生院卒中量表(NIHSS)及日常生活能力(BI)评定两组神经功能缺损程度。结果两组治疗7、14天后 NIHSS 分和 BI 分均较治疗前有明显改善,但治疗组改善程度优于对照组(P <0.01),而发生致死性颅内出血事件并未增加(P >0.05)。结论急性脑梗死尿激酶溶栓术后早期抗凝治疗效果明显,未发生致死性颅内出血,安全有效,值得临床推广。
목적：탐토급성뇌경사뇨격매용전술후조기항응치료적안전성화유효성。방법선택급성뇌경사여동맥용전환자117례,수궤분위치료조여대조조,치료조재용전술후6소시여저분자간소개5000 IU 피하주사2차/d,2주위1료정；대조조재용전술후24소시여이항응치료。량조강압、강당、강화강지、신경보호、방치병발증등기출치료상동,감측활화응혈매원시간(ACT)치。의거미국국립위생원졸중량표(NIHSS)급일상생활능력(BI)평정량조신경공능결손정도。결과량조치료7、14천후 NIHSS 분화 BI 분균교치료전유명현개선,단치료조개선정도우우대조조(P <0.01),이발생치사성로내출혈사건병미증가(P >0.05)。결론급성뇌경사뇨격매용전술후조기항응치료효과명현,미발생치사성로내출혈,안전유효,치득림상추엄。
ABSTRACT:Objective To investigate the security and efficacy of early anticoagulation therapy on arterial thrombolysis with urokinase in acute cerebral infarction (ACI ). Methods A total of 1 1 7 ACI patients with thrombolysis were enrolled.All patients were divided into treatment group and control group.The treatment group was allocated anticoagulation therapy with low molecular heparin calcium 5 000 IU by subcutaneous injection bid after 6 hours of postoperative thrombolysis of ACI with urokinase for 14 days. And the control group was allocated anticoagulation therapy after 24 hours for 14 days.Therapeutic effect was evaluated by the National Insitute of Health Stroke Scale (NIHSS)and the barthel index (BI).Results The scores of NIHSS and BI were obviously improved after 7 and 14 days'treatment in both groups,however,the scores of NIHSS and BI were significantly improved after 7 and 14 days'treatment in treatment group than in control group (P <0.01).The incidence of lethal intracranial bleeding was not increased (P >0.05).Conclusion Early anticoagulation therapy on arterial thrombolysis with urokinase in acute cerebral infarction is safe,effective and worthy of clinical promotion.