动静脉联合溶栓与静脉溶栓治疗急性缺血性脑卒中的对比研究

目的 评估动静脉联合溶栓治疗急性期缺血性脑卒中的疗效和风险.方法 2010年6月-2013年6月收住符合溶栓适应证且无禁忌证的急性期缺血性脑卒中82例按自愿原则,接受动静脉联合溶栓治疗31例,接受静脉溶栓治疗51例,评估治疗后的临床效果.结果 动静脉联合溶栓组溶栓后Ⅱ~Ⅲ级闭塞血管再通率、早期临床神经功能改善率、3个月较好转归率显著高于静脉溶栓组（P＜0.05）,症状性颅内出血发生率、术后3个月的病死率两组无差异（P＞0.05）.结论 相对于静脉溶栓,动静脉联合溶栓具有与之相似的安全性,且动静脉联合溶栓拥有更好的疗效,但该结果仍有待于大样本的随机、双盲对照试验证实.

A Comparison Study between Intravenous and Intra-arterial Thrombolytic Therapy and Intravenous Thrombolytic Therapy in Treatment of Acute Cerebral Ischemic Stroke

Objective To evaluate the therapeutic effects and risk factors of intravenous and intra-arterial throm- bolytic therapy in treatment of acute cerebral ischemic stroke. Methods Eighty-two patients with acute cerebral ische- mic stroke during June 2010 and June 2013 were recruited in this study, and the patients fitted indications without contra- indications of thrombolysis. Based on voluntary principle, 31 patients underwent intravenous and intra-arterial thrombolyt- ic therapy as group A, and 51 patients underwent intravenous thrombolysis therapy as group B. Clinical effects of the two groups were evaluated after treatment. Results Rates of occlusive revascularization of grade 2-3, early improvement rate of clinical nerve function and improved prognosis within 3 months in group A were significantly higher than those in group B （ P 〈 0.05 ）, but the incidence rate of symptomatic intracranial hemorrhage and mortality rate of postoperative 3 months showed no significant differences in the two groups （P 〉 0.05）. Conclusion Compared with intravenous thrombolytic therapy, intravenous and intra-arterial thrombolytic therapy is as safe and effective in treatment of acute cerebral ischemic stroke, but the results need to be further proved by larger scale confrontation test of random and double blind.