急性颈内动脉系统脑梗死的局部动脉溶栓治疗

Local intra-arterial thrombolysis in acute ischemic stroke of the anterior circulation

目的 检验局部注射尿激酶动脉溶栓治疗急性颈内动脉系统脑梗死的安全性和疗效。方法 分析 5 4例接受局部动脉溶栓治疗的颈内动脉系统急性脑梗死患者 ,其中颈内动脉主干闭塞 3例(5 .6 %) ,大脑中动脉主干及分支闭塞 46例 (85 .2 %) ,大脑前动脉闭塞 5例 (9.2 %)。结果 预后好的患者共有 41例 (75 .9%) ,血管再通程度 >5 0 %39例 (72 .2 %) ,再通程度 <5 0 %的 15例 (2 7.8%)。颅内出血率为 2 0 .4%,病死率为 7.4%。结论 局部动脉溶栓是一种有效的治疗方法 ,可以提高血管再通率 ,改善脑梗死患者的预后。

Objective To evaluate the safety and efficacy of local intra-arterial thrombolysis (LIT) using urokinase in patients with acute ischemic stroke of the anterior circulation. Methods Fifty-four patients were treated with LIT using urokinase. The locations of occusion included 3 of internal carotid artery (ICA), 46 of middle cerebral artery (MCA) and 5 of anterior cerebral artery. Results Outcome was good in 41 patients (75.9%). Recanalization >50% was obtained in 72.2% of patients and <50% recanalization in 27.8% of patients. Cerebral hemorrhage occurred in 11 patients (20.4%). Four patients died (7.4%). Conclusion LIT using urokinase can improve the recanalization rate and achieve better functional recovery in patients of acute ischemic stroke.