急性缺血性脑梗死的动脉溶栓治疗

目的 :探讨急性脑梗死行局部动脉内溶栓治疗的临床疗效及安全性。方法 :2 8例自起病至溶栓时间在 1h～ 12h之内的急性脑梗死患者 ,经股动脉插管行全脑血管造影术发现闭塞血管后 ,先用导丝及微导丝通过血栓到达血栓远端 ,撤出导丝后将导管置于靶血管闭塞点或患侧颈内动脉内 ,用注射泵缓慢注射尿激酶行局部溶栓治疗。结果 :2 8例中 14例完全再通 ,8例部分再通 ,6例无效 ,2 4h ,1个月 ,3个月NIHSS评分 ,分别较溶栓前≤ 4分 ,治疗后 3个月神经功能恢复有效率为 70 % (2 2 / 2 8) ,3例合并无症状性脑出血均痊愈。结论 :本组患者血管再通率为 70 % ,经股动脉插管行急性缺血性脑梗死动脉溶栓治疗可使闭塞血管再通 ,此疗法是目前治疗脑梗死有效的治疗手段

The intraarterial thrombolysis in acute ischemic stroke

Objective:To discuss therapeutic effect and safety of the intraarterial thrombolysis in acute ischemic stroke.Methods:28 acute ischemic stroke cases had been treated.The interval from onset of stroke to thrombolysis was 1～12 hours.After founding the occlusive artery by undergoing carotid angiography.Making the microguidewire past through and reach to the distal of the embolus,removing the guidewire then the thrombolytic therapy was performed at the site of occlusion or in the internal carotid artery to inject urakinase.Results:Among 28 cases,complete recanalization occurred in 14 cases;partial recanalization in 8 cases.After thrombolysis threapey 24 hours 1 month and 3 months follow-up evaluations the good outcomes were respectively 15 %,22 % and 44 % of patients.Three months after treatment,the recovert rate was 70 %(22/28).Three cases with symptom brain hemorrhage were cured.Conclusions:The recanalization rate of the patients was 70 %.Intraarterial thrombolysis in acute ischemic stroke can recanalize the occluted vessel.Presently the way is an effective method in the treatment of acute ischemic stroke.