急性脑梗死患者脑动脉、静脉溶栓的临床对比研究

Clinical study on intra-arterial and intravenous thrombolysis in acute cerebral infarction

目的:观察急性脑梗死患者脑动脉内溶栓与静脉内溶栓的疗效及安全性。方法:全部91例患者经临床及头颅CT诊断为急性脑梗死,39例用尿激酶行静脉溶栓,这组患者来自2000～2002年入院患者的统计,作为对照组;另外52例行脑动脉介入溶栓治疗,作为治疗组。治疗前和发病后24h做神经功能缺损评分。结果:两组溶栓治疗后与治疗前相比差异有统计学意义,同时脑动脉溶栓组神经功能缺损评分迅速减少与静脉溶栓组相比有差异有统计学意义,脑动脉组颅内出血率1.5%,静脉组7.7%,两组相比差异有统计学意义。结论:尿激酶脑动脉内溶栓比静脉溶栓相对有效、安全。

Objective To compare the effect and safety of intra-arterial thrombolysis in acute cerebral infarction with that of intravenous thrombolysis. Method 91 acute cerebral infarction patients were included in the study ,diagnosed by CT scan and clinical evaluations. 39 were treated by intravenous urokinase thrombolysis, while 52 received inter-arterial treatments with the same kind of drugs. Neurologic function scores were evaluated before and 24 hours after the managements. Results Inter-arterial thombolysis resulted in a more significant neurologic function scores reduced than intravenous treatments. The significant difference was in the intracranial hemorrhage rate ,with 1.5% in inter-arterial thrombolysis and 7.7% in intravenous treatments. Conclusion Intra-arterial urokinase thrombolysis is more effective and safe than intravenous thrombolysis.