经局部动脉内溶栓治疗急性脑梗塞

Local intra artery thrombolysis for acute cerebral infarction

作者报告经血管内选择性溶栓治疗５例发病在６ｈ内的急性脑梗塞。均经股动脉入路，由全脑血管造影确认脑梗塞区的病变特点，再选择性将导管插入患侧颈内动脉并注入天普洛欣尿激酶行区域性溶栓治疗。５例在溶栓后于３周内神经损害体征基本恢复正常。溶栓的指征和方式取决于术前脑ＣＴ扫描和脑实质血管造影的结果，在脑梗塞后尽快行患侧颈内动脉区域的局部动脉内溶栓有益于闭塞血管再通和侧支循环的建立。

Five patients with acute occlusion of cerebral artery treated with selective intravascular thrombolysis within 6 hours after onset were reported. The features of cerebral infarction were defined firstly, then the catheter was selectively sent into the ipsolateral internal carotid artery via femoral artery in all cases and the urokinase was injected for thrombolytic therapy. The abnormal neurological signs of the 5 cases recovered to normal basically and the patients condition improved apparently in 3 weeks after treatment. The indication and method of thrombolysis depended on the assessment of the pretherapeutic results of CT scan and parenchymography. Emergency local intra arterial thrombolysis in ipsolateral internal carotid artery may be favourable for recanalization of the occluded artery and establishment of collateral circulation.