脑梗死超早期动脉溶栓62例治疗的临床分析

Clinical study of super-early intra-arterial thrombolytic therapy for acute cerebral infarction

目的探讨急性脑梗死的动脉内超早期溶栓治疗疗效。方法对2001年10月-2007年10月用尿激酶进行超早期动脉内溶栓治疗62例急性脑梗死病例进行分析，观察闭塞血管再通和神经功能障碍恢复情况。结果62例患者血栓位置分别为：大脑中动脉主干7例，大脑中动脉分支49例，椎-基底动脉6例。溶栓后血管再通41例，成功再通率为66．13％。54例临床表现改善，治疗前欧洲脑卒中评分量表（ESS）评分47．30±12．78；治疗后ESS评分83．5±24．63，差异有统计学意义（P〈0．01）。结论超早期的动脉内尿激酶溶栓是急性脑梗死治疗的比较安全有效的方法之一。

Objective To evaluate the clinical benefit of super-early intra-arterial thrombolytic therapy for acute cerebral infarction. Methods Case-control study ,review the super-early intra-arterial thrombolytic therapy for sixty-two cases of acute cerebral infarction with urokinase from October 2001 to October 2007,the recanalization degree of occlusive cerebral vascular and the recovery of neurological function were observed. Results Among the sixty-two patients,recanalization was achieved in 41 patients after thrombolysis. Clinical symptoms were completely disappeared and restoration was achieved in 54 patients. The recanalization rate of occlusive cerebral vascular was 66.13%. There was a significant difference of ESS scores between before thrombolysis and after thrombolysis . ESS scores after thrombolysis significantly higher than before（P〈 0. 01）. Conclusion Super-early intra-arterial thrombolytic therapy with urokinase is one of safe and effective choice to the treatment of acute cerebral infarction.