急诊动静脉双途径溶栓和颈动脉支架成形术治疗超早期脑梗死的初步探讨

Preliminary study of intra-venous and intra-arterial thrombolysis and carotid stent angioplasty in patients with ultra-acute cerebral infarction

目的:探讨急诊动静脉溶栓和颈动脉支架成形治疗超早期脑梗死的安全性和有效性。方法:25例发病6h内的脑梗死患者,动静脉双途径溶栓同时行狭窄颈动脉支架成形术。欧洲卒中量表评定缺失神经功能恢复并严密观察并发症的情况。结果:溶栓和支架成形术过程顺利,25例患者神经缺失症状得到满意的恢复,无出血和脑过度灌注综合征等并发症发生。结论:急诊动静脉溶栓和颈动脉支架成形术治疗6h内的第一次发病脑梗死是安全和有效的。

Objective：To evaluate the efficacy and safety of combined intravenous and intra-arterial thrombolysis and stent angioplasty for ultra acute cerebral infarction.Methods：25 patients with ultra acute ischemic stroke within 6 hours after onset were performed the combined intravenous and intra-arterial thrombolysis and carotid artery stent angioplasty.European Stroke Scale（ESS） was used to evaluate the recovery of deficit neurological function for all patients;complications were also under close observations.Results：The procedure of thrombolysis and stent angioplasty was successful technically and the recovery of deficit neurological function was satisfactory in all 25 patients（ESS： 46±15 vs 85±13,P〈0.01）.No complications such as cerebral hemorrhage and high flow perfusion symptoms occurred.Conclusion：Within 6 hours after the first onset,intravenous and intra-arterial thrombolysis combined stent angioplasty in emergency is efficacious and safety for ultra-acute cerebral infarction patients.