动脉内超选择性尿激酶溶解血栓治疗急性缺血性脑梗死
【摘要】
目的 观察动脉内超选择性尿激酶溶解血栓以治疗急性缺血性脑梗死的疗效及并发症。
方法 对46例发病于6 h内的急性缺血性脑梗死患者行动脉内超选择性尿激酶溶解血栓治疗。
结果 经溶解血栓治疗后完全再通24例(52.2%)，部分再通7例(1 5.2%)，未通1 5例(32.6%)；溶解血栓治疗后3个月恢复良好的患者22例，中残5例，重残5例，植物生存6例，死亡8例。3 1例通患者中良好、中残者20例(64.5%)，1 5例未溶通患者中良好、中残者4例(26.7%)，溶栓后脑出血6例(1 3%)。
结论 动脉内超选择性尿激酶溶解血栓能明显提高闭塞血管再通，明显改善预后，是治疗急性缺血性脑梗死的一种有效和相对安全的方法。
【关键词】 脑梗塞；血栓溶解疗法；尿激酶；输注，动脉内
Intra—arterial superselective thrombolytic therapy for acute cerebral infarction
LIN Gui-jun，HU Shi—wen，LIU Zong-ming，LIU Ai—xian，JIA Ji—ming.Department of Neurosurgery，the Areospacecentral Hospital，Bei—jing，100039，China
【Abstract】
Objective To observe the efficacy and complication of intra—arterial superselective thrombolysis using urokinase for acute ischemic stroke.
Methods 46 patients of acute ischemic stroke within 6h trom onset were treated by intra-arterial superselectlve thromboNtic theraov using urokinase.
Results Complete recanalization j ust after thrombolysis were observed in 24 of the 46 patients(1 5.2%)，no recanalization in 1 5 of the 46 patients(32.6%)，and cerebral hemorrhages occurred in 6 patients after thrombolysis.The clinical outcome 3 months after thrombolysis was evaluated according to Glasgow outcome scale.22 patients were good recovery，5 patients were moderate disability，5 patients were severe disability，6 patients were vegetative state，and 8 patients died.20 of the 3 1(64.5%)patients of complete/partialrecanalization were good recovery or moderate disability，only 4 of the 1 5(26.7%)patients of no recanalization were good recovery or moderate disability.
Conclusion Intra-arterial superselectlve thrombolvsis can apparently lml3rove the rate of recanallzation and clinical outcome. It is an effective and relatively safe therapy in treatment of acute ischemic stroke.
【Key words】 Cerebral infarction；Thrombolytic therapy； Urokinase； Intraarterial, http://www.100md.com(林贵军 胡世文 刘宗明 刘爱贤 贾继明)
目的 观察动脉内超选择性尿激酶溶解血栓以治疗急性缺血性脑梗死的疗效及并发症。
方法 对46例发病于6 h内的急性缺血性脑梗死患者行动脉内超选择性尿激酶溶解血栓治疗。
结果 经溶解血栓治疗后完全再通24例(52.2%)，部分再通7例(1 5.2%)，未通1 5例(32.6%)；溶解血栓治疗后3个月恢复良好的患者22例，中残5例，重残5例，植物生存6例，死亡8例。3 1例通患者中良好、中残者20例(64.5%)，1 5例未溶通患者中良好、中残者4例(26.7%)，溶栓后脑出血6例(1 3%)。
结论 动脉内超选择性尿激酶溶解血栓能明显提高闭塞血管再通，明显改善预后，是治疗急性缺血性脑梗死的一种有效和相对安全的方法。
【关键词】 脑梗塞；血栓溶解疗法；尿激酶；输注，动脉内
Intra—arterial superselective thrombolytic therapy for acute cerebral infarction
LIN Gui-jun，HU Shi—wen，LIU Zong-ming，LIU Ai—xian，JIA Ji—ming.Department of Neurosurgery，the Areospacecentral Hospital，Bei—jing，100039，China
【Abstract】
Objective To observe the efficacy and complication of intra—arterial superselective thrombolysis using urokinase for acute ischemic stroke.
Methods 46 patients of acute ischemic stroke within 6h trom onset were treated by intra-arterial superselectlve thromboNtic theraov using urokinase.
Results Complete recanalization j ust after thrombolysis were observed in 24 of the 46 patients(1 5.2%)，no recanalization in 1 5 of the 46 patients(32.6%)，and cerebral hemorrhages occurred in 6 patients after thrombolysis.The clinical outcome 3 months after thrombolysis was evaluated according to Glasgow outcome scale.22 patients were good recovery，5 patients were moderate disability，5 patients were severe disability，6 patients were vegetative state，and 8 patients died.20 of the 3 1(64.5%)patients of complete/partialrecanalization were good recovery or moderate disability，only 4 of the 1 5(26.7%)patients of no recanalization were good recovery or moderate disability.
Conclusion Intra-arterial superselectlve thrombolvsis can apparently lml3rove the rate of recanallzation and clinical outcome. It is an effective and relatively safe therapy in treatment of acute ischemic stroke.
【Key words】 Cerebral infarction；Thrombolytic therapy； Urokinase； Intraarterial, http://www.100md.com(林贵军 胡世文 刘宗明 刘爱贤 贾继明)