老年颈内动脉系统急性脑梗死动脉溶栓的疗效观察

Aged Carotid Arterial Thrombolysis in Acute Cerebral Infarction Efficacy

目的:探讨老年颈内动脉系统急性脑梗死动脉溶栓的疗效。方法:对我院老年科收治的63例老年颈内动脉系统急性脑梗死随机分为股动脉组以及颈动脉组,其中股动脉组患者30例,对其采用经皮股动脉穿刺微导管介入尿激酶溶栓治疗,颈动脉组患者33例,对其采用经皮患侧颈动脉穿刺尿激酶溶栓治疗。结果:对两组患者治疗前、术后2h以及术后30d采用NIHSS评分比较,两组患者NIHSS评分在术后2h及术后30d均较术前有明显改善(P<0.05);对两组患者治疗相关情况比较,股动脉组患者术后2h血管再通率明显高于颈动脉组(P<0.05),两组颅内出血率未显示出统计学差异性;对两组患者术后30d牛津残障OHS评分、BI指数比较,股动脉组患者明显优于颈动脉组(P<0.05)。结论:对老年急性脑梗死患者采用经皮股动脉穿刺微导管介入或采用经皮患侧颈动脉穿刺尿激酶溶栓治疗,均可有效改善患者预后,提高患者的临床疗效,两组相比较,股动脉组更能显示出优良的治疗率。

Objective： To investigate the thrombolysis treatment for elderly patients with acute carotid arterial cerebral infarction. Methods： 63 elderly patients admitted to hospital with acute cerebral infarction were randomly divided into experimental group and control group. In the experimental group, 30 patients had micro-catheter interventional urokinase thrombolytic therapy via percutaneous femoral artery puncture. In control group, 33 patients received urokinase thrombolyfic therapy via ipsilateral percutaneous carotid artery puncture. The NIHSS scores which were applied to patients before operation, 2h after operation and 30d after operation, the Oxford handicap score （OHS） and BI index were compared between the two groups. Results： The NIHSS scores of 2h after operation and 30d after operation were significantly improved in both groups as compared with that preoperative （P〈0.05）. As for the 2h-postoperative vascular recanalization rate, the experimental group showed a higher rate than the control group （P〈0.05）. There was no statistical difference in rate ofintracranial hem- orrhage between the two groups. As for the OHS and BI index, the experimental group had significantly better results than the control group （P〈0.05）, Conclusion： For the elderly patients with acute cerebral infarction, urokinase thrombolytic therapy by percutaneous femoral artery puncture with micro-catheter or by the ipsilateral percutaneous carotid artery puncture could improve the prognosis and clinical efficacy of patients. The urokinase thrombolytic therapy by percutaneous femoral artery puncture showed higher curative rate.