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目的:对超过溶栓治疗时间窗的脑梗死患者,作静脉溶栓疗效和安全性的探讨。方法:将72例急性脑梗死患者随机分为尿激酶溶栓组48例和对照组24例。溶栓组的病人,根据其溶栓治疗的时间.再分为早期溶栓组(6 h内)和超时间窗溶栓组(12～24 h)。结果:超时溶栓组治疗有效率明显高于对照组,与早期溶栓组无显著差异,无严重副作用。治疗后脑CT扫描超时溶栓组梗死面积大于早期溶栓组,但明显小于对照组。结论:在注重治疗时间窗个体化的基础上,联合应用脑保护剂,适当放宽溶栓治疗时间窗的超时溶栓是安全有效的。
Objective: To investigate the efficacy and safety of intravenous thrombolysis in patients with cerebral infarction over the thrombolytic time window. Methods: Seventy-two patients with acute cerebral infarction were randomly divided into urokinase thrombolytic group (n = 48) and control group (n = 24). Patients in the thrombolysis group were further divided into early thrombolytic group (within 6 h) and thrombolytic group (12 to 24 h) according to the time of thrombolytic therapy. Results: The effective rate of overt thrombolytic group was significantly higher than that of the control group, no significant difference with the early thrombolysis group, no serious side effects. After treatment, the cerebral infarction area in overt thrombolysis group was larger than that in early thrombolysis group, but significantly smaller than that in control group. Conclusion: On the basis of paying attention to the individualization of treatment time window, it is safe and effective to use brain protective agent in combination and to relax the overtime thrombolysis of thrombolytic treatment time window appropriately.