超选择性动脉溶栓治疗急性脑梗死39例临床分析

Superselective intra-arterial thrombolysis for acute cerebral infarction

目的探讨急性脑梗死患者动脉溶栓治疗的有效性和安全性。方法 39例急性脑梗死患者,采用超选择性动脉溶栓的方法,尿激酶以1万U/min持续泵入,总量为50-100万U,平均73.5万U。并比较溶栓前、后1、7、14天的NIHSS评分。结果 39例患者颈内动脉闭塞4例,大脑中动脉主干闭塞14例,大脑中动脉分支15例,椎-基底动脉系统血管闭塞6例。闭塞再通情况,颈内动脉2例,大脑中动脉主干10例,大脑中动脉分支9例,椎-基底动脉系统5例。结论超选择性动脉溶栓治疗能明显提高血管再通率,明显改善预后,是治疗急性脑梗死比较安全和有效的方法。

Objective To discuss the effect and security of superselective intra-arterial thrombolysis for treatment of acute cerebral infarction.Methods 39 patients with acute cerebral infarction were enrolled in the present study.Urokinase was administered locally through the microcatheters by the micro pump at the rate of 10,000 unit/min.The total dosage of UK was 500,000 units to 1000,000 units and the average dosage was 735,000 units.The cases were assessed by NIHSS score before the treatment,1 day,7 days and 14 days after the treatment.Results Of the 39 cases there were 4 cases in ICA,14 in middle cerebral artery,15 in the branches of middle cerebral artery and 6 in vertebro-basilar artery.2 recanalizations were achieved in ICA occlusions,10 in middle cerebral artery（MCA）,9 in the branches of middle cerebral artery,and 5 in vertebrobasilar artery.Conclusion Superselective intra-arterial thrombolysis can apparently improve the rate of recanalization,which is effective and safe in the patients with acute cerebral infarction.