动脉溶栓介入治疗急性脑梗死的临床研究

Clinical observation of the therapeutic effect of local intra-arterial thrombolysis intervention on acute cerebral infarction

目的研究局部注射尿激酶动脉溶栓治疗急性脑梗死的安全性、疗效及预后相关因素。方法对94例发病在24h内的急性脑梗死患者行局部动脉内溶栓治疗。分析血管再通程度、治疗时间与临床疗效。结果94例中有效72例(76.6%);血管再通程度≥50%67例(71.28%)中有效64例(95.52%),血管再通程度<50%27例(28.72%)中有效8例(29.63%),两者比较差异有显著意义(P<0.05);发病<6h的48例中有效41例(85.42%),6～24h的46例中有效31例(67.39%),两者比较差异有显著意义(P<0.05)。发生颅内出血16例(17.02%)。结论局部动脉溶栓治疗急性脑梗死是安全、有效的治疗方法。

Objective To observe the safety and efficacy of local intra-arterial thrombolysis using urokinase in patients with acute cerebral infarction, and to analyze the predictive factors related to the outcome. Methods 94 patients with acute cerebral infarction who were at onset within 24 hours were treated with local intra-arterial thromblysis using urokinase. Angiographic recanalization degree, treatment time and clinical efficacy were analyzed. Results Among 94 patients, effective rate was 76.6% （72 cases） ;67 cases （71.28%） were with recanalization degree≥50% in which 64 cases （95.52%） had obvious efficacy; among 27 cases（28.72% ） with recanalization degree 〈 50%, 8 cases （29.63 % ） had obvious efficacy, there was a significant difference between the two groups （ P 〈 0.05）. Among 48 patients who were at onset less than 6 hours,41 cases （85.42%） had efficacy;46 patients who were at onset between 6 hours and 24 hours, 31 cases （67.39%） had efficacy. There was a significant difference between the two groups （ P 〈 0.05）. Cerebral hemorrhage occurred in 16 patients （17.02%）. Conclusion Local intra-arterial thromblysis using urokinase is a feasible, effective and safe therapy in the treatment of acute cerebral infarction,which can improve the recanalization rate and achieve better functional recovery.