动脉溶栓及经皮腔内血管成形术治疗急性脑梗塞

Combined selective intravascular thrombolysis and perculaneous transluminal angioplasty for acute ischemic stroke

目的 评价超选择动脉溶栓及经皮腔内血管成形术（PTA）治疗急性脑梗塞的临床疗效。方法 对30例急性脑梗塞病人，经股动脉或颈动脉插管，用微导丝将微导管送至血管闭塞部位，注入尿激酶（UK）行溶栓治疗，对6例颅外段血管狭窄者，采用PTA消除，并注入罂粟碱扩张颅内血管。结果 颈内动脉闭塞10例、大脑中动脉16例、椎基底动脉系统4例中，血管完全再通15例，部分再通12例，治疗3个月后日常生活能力指数（BI）评分：100分20例，75～95分6例，占86．67％。结论 早期超选择动脉溶栓配合PTA和罂粟碱可明显提高闭塞血管再通率，是目前治疗急性脑梗塞有效的方法。

Objective To evaluate the therapeutic effect of the selective intraarterial thrombolysisSIT and perculaneous transluminal angioplasty PTA for acute ischemic stroke． Method 30 acute ischemic stroke cases had been treated． Making the microguidewire past throuth and reach to the embolus removing the microguidewire then the thrombolysis therapy was performed by local intravascular infusion of Urokinase at the site of occlusion． PTA was used to eliminate the stenosis in extracranial arterial in 6 cases combined with infusion of papaverine． Result Among the 10 cases with occlusion of internal carotid artery 16 cases with occlusion of middle cerebral artery and 4 cases with occlusion of vertebralis artery 15 cases were completely recanalized 12 cases were partially recanalized． three months after treatment the recovery rate of neurologic deficits was 86．67％26//30． Conclusion SIT combined with PTA and papaverine is a effective method in the treatment of acute ischemic stroke．