溶纤、抗凝、解聚治疗急性脑梗死微栓子监测

目的应用多通道（multi－Depx4）TCD（经颅多普勒）对急性脑梗死应用溶纤、抗凝、解聚治疗时对脑微栓子监测。方法2MHz监测探头，应用鼻架式支架，固定于两侧颞窗，探测左右MCA（大脑中动脉）监测30分钟。结果1组常规药物治疗组33例，微栓子（MES）阳性者22例．占66．7％。Ⅱ组应用降纤酶或尿激酶溶纤或肝素抗凝治疗共18例，MES阳性者4例，占22．2％。Ⅲ组服用阿斯匹灵解聚治疗32例．MES阳性者5例占15．6％。Ⅱ、Ⅲ组MES阳性共9例占18％。Ⅳ组正常健康对照组30例．MES皆阴性。结论多通道MDX4型TCD进行MES监测急性脑梗死应用溶纤、抗凝、解聚药物，MES发生率下降，占18％．而一般治疗MES发生率高．占66．7％，急性脑梗死和对照组相比，MES阳性率为36．14％。

Monitor MES in treating acute cerebral infarction with anti-coagulation fibrinolytic and anti-aggregation method

Purpose Monitor MES using multi-Dopx4 TCD when treating acute cerebral infarction with anti--coagulation, fibrinolytic and anti-aggregation method. Method 2MHz transducer is fixed on the bilateral temporal windows by nasalstand to monitor right and left MCA for 30 minutes. Result Group Ⅰ(treating with regular method): 33 cases, 22 cases (66. 7%) show positive MES resultst Group Ⅱ(treating with fibrinolytic method using defibrase of urokinase or heparin): 18 cases, 4 cases (22. 2%) show positive MES resultsl GroupⅢ (using aspirin for anti-aggregation treatment): 32 cases, 5 cases (15. 6%) show positive MES results. Among GrouP Ⅰ and Ⅱ, 9 cases (18%) show positive MES results. Group Ⅳ (normal contrast group): 30 cases, all show negative MES results. Conclusion: Using multi-Dopx TCD to monitor MES can record and identify MES automatically, and this agrees with the conclusion of the foreign schoolars. are the first to be reported in China. Monitoring of MES in the Treatment of Acute Cerebral Infarction with fibrinolytic, anti-coagulation and anti--aggregation methods can reduce MES rate (18% ), while routine treatment will cause high MES rate (66. 7 % ). As compared with contrast group. cases with acute cerebralvascular infarction show positive MES rate (36. 14%).