同步等量液体置换血栓碎吸装置在动脉溶栓中的实验研究

Experimental study of intra-arterial thrombolysis by thrombnus absorption device plus synchronous replacement with same amount liquid

目的验证同步等量液体置换血栓碎吸装置在动脉溶栓中的应用价值。方法成年杂种犬8只,建立急性脑栓塞模型,随机分为对照组(n=4)和实验组(n=4),对照组经微导管灌注尿激酶溶栓,实验组采用同步等量液体置换血栓碎吸装置并用尿激酶动脉溶栓,观察两组尿激酶用量、溶栓所需时间及两组动物的血管再通率,同时监测血凝功能,CT/MRI检查了解脑梗死或脑出血的发生情况,所有动物溶栓完后取栓塞侧颈总动脉行病理学检测。结果实验组血管再通时间较对照组大大缩短[(25.0±4.3)min vs(159.3±49.8)min,P<0.01],实验组血管再通率(100%)明显高于对照组(80%,P<0.05);实验组未见明显的脑梗死,对照组发生脑梗死3例,其中1例为半球梗死;两组均未发生脑出血征象,两组颈动脉壁均未受到损伤。结论脑大动脉急性闭塞时,采用该装置并尿激酶溶栓,效果良好,具有很好的应用前景。

Objective To verify the application value of thrombnus absorption device plus synchronous replacement with same amount liquid in intra-arterial thrombolysis. Methods Acute cerebral embolism model was established in 8 adult hybrid dogs that were then randomly divided into 2 groups： control group（ n = 4）and experimental group （n = 4）. The perfusion of urokinase through micro- cather was performed in control group, while thrombnus absorption device plus synchronous replacement with same amount liquid was applied in urokinase thrombolytic therapy in experiment group. The dosage of urokinase,the time for thrombolysisis and the reopen rate of blood vessel were observed and blood coagulation function was detected. CT and MRI were performed to evaluate the occurrence of cerebral infarction and hemorrhage. After thrombolysis, the common carotid arteries of the side with thrombnus were taken out and examined in pathological study. Results The time for repass of the blood vessels in experiment group was much shorter than that in control group [ （25.0 ±4.3）rain vs （159.3 ±49.8）min,P 〈0.01 ]as well as the reopen rate（ 100%/80% ,P 〈0.05） ;no cerebral infarction occurred in experiment group,while there were 3 cases in control group including 1 once of cerebrum hemispheric infarction; no symptoms of cerebral hemorrhage were found in both groups and no injury of carotid artery wall was detected out in both group. Conclusions It is of good effects of the device combined with urokinase on thrombolysis in the cases of acute cerebral embolism.