局部动脉溶栓治疗急性前循环脑梗死临床观察

The clinical observation of local intraarterial thrombolysis in acute ischemic stroke of the anterior circulation

目的评价局部动脉溶栓治疗急性前循环脑梗死的近期效果。方法对24例发病在8h内的急性前循环脑梗死患者行局部动脉溶栓治疗。根据血管造影按血管再通程度分为完全再通、部分再通和未再通。临床结果评价在溶栓后30d进行，根据Modified Rank Score（MRS）分为治疗效果好（MRS0-Ⅲ）、治疗效果差（MRSⅣ-Ⅵ）两类。结果完全再通率54．2％（13／24），部分再通率25．0％（6／24）。溶栓后30d，治疗效果好的患者有15例（62．5％），出血率为16．7％（4／24），病死率为16．7％（4／24）。结论局部动脉溶栓治疗急性颈内动脉系统脑梗死是一种有效方法，但安全性和远期疗效还有待于进一步观察。

Objective To evaluate the short-term outcome of local intraarterial thrombolysis in patients with acute ischemic stroke of the anterior circulation. Methods 24 patients with acute ischemic stroke of the anterior circulation within 8 hours were treated by local intraarterial thrombolysis. Arterial recanalization was divided into total, partial and occlusive respectively according to angiography. Evaluation of clinical outcome was performed on the 30th day after thrombolysis, and was classified as good for Modified Rankin Scale （MRS） scores of 0 to III and poor for MRS scores of IV to VI. Results Total recanalization was obtained in 54.2 % of patients, partial recanalization in 25.0%. Clinical outcome was good in 15 patients （ 62.5% ）. Cerebral hemorrhage occurred in 4 patients （ 16.7% ）. Four patients died （ 16.7% ）. Conclusion Local intraarterial thrombolysis is an effective method for treatment of acute ischemic stroke of the anterior circulation. It needs further practice and long-term follow-up study on safety and long-term efficacy.