急性缺血性脑卒中患者选择性脑动脉介入溶栓治疗的效果观察

Effect observation of selective cerebral arterial thrombolytic therapy in acute ischemic stroke patients

目的:观察急性缺血性脑卒中患者经导管选择性脑动脉内介入溶栓的疗效。方法:急性脑梗死患者48例,随机分为2组,对照组30例采用小剂量尿激酶(20万U)静脉滴注,连续7d。观察组18例,行全脑血管DSA造影,明确责任血管后超选择插至病变血管,应用尿激酶进行动脉溶栓治疗。所有患者在治疗前,治疗后24h,3d,14d后进行中国卒中量表(CSS)测定分析,并比较疗效。结果:治疗组治疗前和治疗14天后神经功能缺损评分分别为(22.0+9.0)分和(8.0±8.0)分,治疗前后相差非常显著(P<0.01);对照组治疗前和治疗14天后神经功能缺损评分分别为(20.0±10.0)分和(15.0±9.0)分。神经功能缺损评分治疗前两组无明显差别(P>0.05),治疗后两组相差非常显著(P<0.01)。治疗组总有效率(治愈+显效+进步)为88.9%(16/18),对照组总有效率为70%(21/30),两组差异显著(P<0.05)。结论:经导管选择性动脉溶栓治疗急性缺血性脑卒中疗效较静脉溶栓更为确切,安全简单。

Objective：To observe the effect of acute ischemic stroke cases treated by trans-catheter cerebral arterial thrombolytic therapy. Methods： Forty eight patients with acute cerebral infarction were divided into treated group （n=18）and control group（n=30）randomly. The control group was treated with urokinase 200,000 units/day intravenous for 7 days. Eighteen cases of treated group were performed DSA for whole brain vessels. After the offending vessels were identified,the lesion vessels were intubated super-selectively and underwent thrombolysis with urokinase. CSS and the curative effect were compared before treatment ,24h,3d and 14 d after treatment in all groups. Results： Neurological deficit scores of treated group before treatment and 14d after treatment were（22.0＋9.0）score and（8.0±8.0）score in which the difference was very significan（tP0.05）in every group before treatment, but very significant difference （P〈0.01） after treatment. The total effective rate of treated group was 88.9%,was 70% in control group in which the difference of two groups was very significant（P〈0.05）. Conclusion： Compared to intravenous thrombolysis,the effect of acute ischemic stroke cases treated by trans-catheter cerebral arterial thrombolytic therapy are more exactly ,safe and simple.