超选择性动脉内溶栓联合选择性脑低温保护治疗大脑中动脉闭塞的临床分析

Clinical analysis of the middle cerebral artery occlusion treatment by superselective intra - arterial thrombolysis combined with selective cerebral hypothermia protection

目的评价超选择性动脉内溶栓（SIAT）联合选择性脑低温保护治疗大脑中动脉（MCA）闭塞的血管再通率、临床疗效和安全性。方法回顾性分析13例采用超选择性动脉内溶栓联合选择性脑低温保护治疗大脑中动脉闭塞患者的临床资料。用TIMI评价血管再通程度；治疗前、治疗后即刻、第7天、1个月、3个月NIHSS评分，治疗后6个月改良Rankin量表（mRS）评分和出血转化（HT）评价预后。结果9例获得大脑中动脉完全再通．2例获得部分再通，2例没有发生再通。随访6个月，7例生活能完全自理，3例生活能部分自理，2例无法生活自理，1例死亡。术后并发脑出血3例。结论超选择性动脉内溶栓联合选择性脑低温保护治疗大脑中动脉闭塞是安全和有效的。

Objective To evaluate the middle cerebral artery （MCA） occlusion recanalization rate, clinical efficacy and safety of superselective intra-arterial thrombolysis （SIAT） combined with selective cerebral hypothermia protection. Methods The clinical datas of 13 cases of the MCA occlusion treatment by SlAT combined with selective cerebral hypothermia protection were retrospectively analyzed. Evaluation of recanalization with the TIMI degree; neural function of patients was evaluated by NIHSS score at 0 day, 7 days, 1 month and 3 months after treatment, as well as at 0 day before treatment ; prog- nosis of patients were evaluated by Rankin Scale （mRS） score and hemorrhagic transformation （HT） Results There were 9 patients whose middle cerebral artery was recanalization completely; 2 patients whose middle cerebral artery was recanalization partially; 2 patients whose middle cerebral artery was not recanalization. Followed up for 6 months, There were 6 patients who could take care of themselves completely ; 4 themselves patients w partially ; 2 take care of themselves 1 patient who was died ho could take care of patients who could not completely ; There were There were 3 patients who happen to be cerebral hemorrhage after surgery. Conclusions SIAT combined with selective cerebral hypothermia protection for the treatment of the MCA occlusion is safe and effective.