急性闭塞性脑梗塞介入溶栓术临床分析

Clinical Analysis of the Interventional Fibrinolytic Therapy of Patients with Acute Cerebral Occlusive Infarction

目的：通过介入溶栓治疗急性闭塞性脑梗塞,观察临床效果、预后。方法：选取我院2009年~2011年间收治急性闭塞性脑梗塞患者44例,均经介入溶栓治疗。结果：发病〈3h患者26例,总有效率为92.31%;（3~6）h患者18例,总有效率为55.56%,治疗前后NIHSS对比发病〈3h患者治疗后,效果明显优于（3~6）h患者,出现7例颅内出血患者,为大脑中动脉闭塞,均为无症状脑出血,死亡2例。5例脑出血患者伴随高血压4例,糖尿病1例,均表现为脑水肿,积极对症脱脑水肿治疗后好转。2例脑水肿严重,形成脑疝,治疗后出现再栓塞,治疗无效死亡。结论：急性闭塞性脑梗塞运用介入溶栓治疗,发病时间越短疗效越好,更有利于观察闭塞和再通情况,且见效快、疗效好,只要是严格按照手术适应症进行,可以有效降低并发症风险。

Objective：Through the interventional thrombolytic treatment for acute occlusion of cerebral infarction,the clinical effect was observed,prognosis.Methods：Selection of our hospital from 2009 to 2011 acute cerebral infarction patients treated44 patients,were treated by interventional therapy.Results：Incidence of 26 3H patients,the total effective rate was 92.31%;18 cases were the patients with（3~6）h,the total efficiency of 55.56%,before and after treatment with NIHSS comparative onset 3H patients after treatment,effect is obviously superior to those of（3~6）h patients,7 cases with intracranial hemorrhage,for middle cerebral artery occlusion,were asymptomatic cerebral hemorrhage,2 cases of death.In 5 patients with cerebral hemorrhage with hypertension in 4 cases,1 cases of diabetes mellitus,showed brain edema,brain edema positive symptomatic and recovered after the treatment of.In 2 patients with cerebral edema in severe cerebral hernia after treatment,form,and embolization,therapeutic and death.Conclusion：Acute cerebral infarction by interventional thrombolytic therapy,onset time shorter the better curative effect,more conducive to the observation of occlusion and recanalization,and fast effect,good curative effect,as long as it is in strict accordance with the operation indications,can effectively reduce the risk of complications.