动脉内溶栓治疗急性脑梗死

Intra-arterial Thrombolysis in Acute lschemic Stroke

为了前瞻性研究局部动脉内溶栓治疗急性脑梗死的疗效，应用超导技术对３７例急性脑梗死病人临近梗死部位的脑血管内注入溶栓药物治疗。其中２２例使用蝮蛇抗栓酶３号，１５例使用尿激酶溶栓。结果：２７．０３％的患者在６小时内溶栓，２４．３２％在７～１２小时内，２１．６３％在１３～２４小时内，２４．３２％在２５～４８小时内，２．７％在４８小时以后溶栓。溶栓后症状明显好转者占５９．５％，好转者２１．６％，无改善１８．９％，其中２例于溶栓后９天及１个月死亡。两种药物组疗效差异无统计学意义。术后血管再通及侧支循环开放率为７４．３％。结论：早期局部血管内溶栓治疗对脑梗死疗效显著。

To assess the efficacy of intra-arterial thrombolysis for acute ischemic stroke patients. Methods: There were 37 acute ischemic stroke cases in this study. 22 cases used Ahalysantifarctasi purificati for intra-arterial thrombolysis, 15 cases used urokinase for it. 27. 03 % of patients started thrombolysis within 6 h, 24. 32 % within 7-12 h, 21.63% within 13-24 h,24. 32% within 25 - 48 h, 2.7% after 48 h. Results: After intra-arterial thrombolysis, there were 59.5 % of patients who had much improvement of symptoms, improvement rate was 21. 6 %, no change in 18. 9%. There were 2 cases died 9 days and 1 month later. Using Ahalysantifarctasi purificati for thrombolysis, there were improvement of symptoms in 77. 2% of patients, urokinase in 86. 6 %, between the two drugs there was no statistically significant difference. There were 74. 3 % of infarcted vessels which were patent to the collateral circulation. Conclusion: The local intra-arterial thrombolysis is of benefit for the acute ischemic stroke in the earlier stage.