超选择性动脉溶栓治疗急性脑梗死的临床研究

Clinical research of the combination of early selective arterial thrombolytic therapy in treating acute cerebral infarction

目的:研究急性脑梗死超早期选择性动脉内溶栓的疗效及预后。方法:60例急性脑梗死患者发病6h内均在CT检查、MRI+MRA及血管造影基础上接受超选择性动脉溶栓治疗。分别于溶栓前、后不同时间根据Barthel指数(BI)评分及美国国立卫生院卒中量表(NIHSS)评价患者运动功能。结果:溶栓治疗有效率达93%,显效率达76.6%,血管再通率达86.7%以上。治疗后BI评分较前增加(P<0.05),NIHSS评分较前降低(P<0.05)。结论:超早期选择性动脉内溶栓治疗急性脑梗死,不仅能恢复患者脑部血流灌注、再通闭塞的血管,重建血流,而且能阻断脑梗死的病理过程。从而挽救缺血半暗带,明显改善患者的功能预后,是治疗急性脑梗死安全有效的方法。

Objective：Ecacy study of the combination of early selective arterial thrombolytic therapy in treating acute cerebral infarction and prognosis. Method：60 patients with acute cerebral infarction patients, on the basis of the CT scan, MRI, MRA and angiography within six hours of onset, would receive super selective intra-arterial thrombol- ysis. Evaluate patients＇ motor function at different times before and after thrombolysis according to the Barthel Index （BI） score and the U.S. National Institutes of Health Stroke Scale （NIHSS）. Result：the effective rate is 93%, markedly effective rate is 76.6%, and the recanalization rate is 86.7% or higher. Conclusion＇This kind of combined method can not only restore the patient＇s brain blood flow perfusion, recanalize occluded blood vessels and rebuild the blood flow, but also it can block the pathological process of cerebral infarction to thereby save the ischemic penumbra and significantly im- prove the functional prognosis of the patients. It has proved to be a safe and effective treatment of acute cerebral infarction.