经动脉内间断加压灌注治疗低灌注性脑缺血的初步探讨

Preliminary study on treatment of hypoperfusion ischemia of brain with arterial intermittent pressure perfusion

目的探讨经血管内选择性加压灌注治疗低灌注性脑缺血的方法及其可靠性.方法对11例持续头晕、或短暂性脑缺血发作、部分视物不清和失语患者,在除外颅内外动脉狭窄后,采用经椎动脉或颈动脉内间断加压的方法将纤溶药物直接注入脑低血流灌注区.结果术后1周内,神经缺损症状均有不同程度的改善,术前和术后的脑灌注核磁影像对比,缺血区脑血流影像得到显著增强.随访5个月～3年病情无复发.结论局部加压灌注治疗低灌注性脑缺血,可以改善脑缺血区微循环,增加血氧供应,改善临床症状.

Objective To evaluate the reliability and method of intermittent pressure perfusion by the way of carotid and vertebral arteries in treatment of hypoperfusion cerebral ischemia. Method Eleven cases with continuous dizziness, TIA, aphasia and blurred vision were given injection of urokinase into ischemic area of brain by intermittent pressure method via carotid and vertebral arteries. Results The neurological deficits were obviously improved to various degrees and the blood flow on PWI image of ischemic area in brain was markedly increased compared with pre-operative and post-operative PWI images in 10 cases one week later. No recurrence of symptoms and signs was found in following 5 to 36 months. Conclusion Intermittent pressure perfusion could improve microcirculation in ischemic area, increase blood and oxygen supply and improve clinical symptoms. It can be one of the effective methods to correct hypoperfusion cerebral ischemia.