局部动脉溶栓联合机械碎栓治疗急性脑梗死的临床应用

目的：探讨局部动脉溶栓联合机械碎栓治疗急性脑梗死的可行性、安全性及疗效。方法：通过对18例急性脑梗死患者实施局部动脉内尿激酶溶栓联合机械碎栓治疗,其中,颈内动脉闭塞5例,大脑中动脉闭塞9例,大脑前动脉闭塞4例。从发现症状到溶栓治疗时间均为6 h以内,全组均经CT证实无脑出血。结果：18例颈内动脉系闭塞患者中16例血管完全或部分再通,2例未通。结论：超选择性局部动脉溶栓联合机械碎栓治疗6 h以内急性脑梗死,能使闭塞血管尽快开通,是一种比较安全有效的治疗方法。

Clinical applications of arterial thrombolysis combined with mechanical thrombectomy for acute cerebral infarction

Objective： To study the feasibility,safety and efficacy of local arterial thrombolysis combined with mechanical thrombectomy in the treatment of acute cerebral infarction.Methods： 18 cases of patients with acute cerebral infarction including carotid artery occlusion（5 cases）,middle cerebral artery occlusion（9 cases） and anterior cerebral artery occlusion（4 cases） were treated by local intra-arterial thrombolysis with urokinase and mechanical fragmentation.All patients were within 6 hours from reporting symptoms to thrombolytic therapy and confirmed no cerebral hemorrhage by CT scan.Results： Among 18 patients with artery occlusion,16 were partially or completely recovered,2 cases were not recovered.Conclusion： For patients with acute cerebral infarction within 6 hours,highly selective local intra-arterial thrombolysis combined with mechanical fragmentation treatment can open blood clots safely and effectively.