动脉内溶栓治疗急性脑梗死的疗效观察

Thearpeutic effect observation of intra-arterial thrombolysis for treatment of acute cerebral infarction

目的探讨动脉内溶栓治疗急性脑梗死（ACI）的疗效。方法对15例ACI患者采用股动脉插管行动脉注射尿激酶溶栓治疗,并在治疗前后分别行DSA检查;治疗前、治疗后2h、48h、15d及30d分别采用欧洲卒中量表（ESS）、美国国立卫生研究院卒中量表（NIHSS）及Barthel指数（BI）进行评分及疗效评定。结果溶栓后12例闭塞侧大脑中动脉完全再通。溶栓后各时间点ESS、NIHSS和BI评分较治疗前显著改善（P〈0.05-0.01）;基本痊愈8例,显效5例,显效率86.7%。未见明显不良反应。结论动脉内尿激酶溶栓是治疗ACI的有效方法。

Objective To investigate the therapeutic effect of intra-arterial thrombolysis （IATT） in acute cerebral infarction（ACI）. Methods 15 patients with ACI were treated with IATT using Urokinase （UK）. All patients were assessed by DSA before and after IATT. The stroke scale （ ESS and NIHSS） and Barthel Index （ BI ） were used before and 2 h,48 h,15 d ,30 d after treatment for appraising thearpeutic effect . Results After IATT, the sides of obliterated middle cerebral artery in 12 patients were completely re-circulated. Compared with before IATT, the scores of ESS, NIHSS and BI were significantly improvement at 2 h,48 h,15 d and 30 d after IATT（P 〈 0. 05 -0. 01 ）. 8 cases were recovery, 5 cases were obvious improvement, the total effective rate was 86.7%. There was no obvious adverse reaction. Conclusion IATT with UK is the effective way for treatment of ACI.