急性脑梗死溶栓治疗的时间窗及其影响因素分析

目的 分析急性脑梗死患者不同时间的动脉内溶栓治疗效果,探讨影响治疗时间窗的因素.方法 54例脑梗死患者均在CT检查及血管造影基础上接受选择性动脉溶栓治疗其中在6 h以内溶栓者42例,6～24 h溶检者12例.统计两组患者术后血管再通率和神经功能缺失积分差值.结果 两组患者治疗有效率分别为88.1%和75.0%,显效率分别为71.4%和50.0%, 管再通率分别为69.0%和50.0%,血管再通中位时间分别为68和73min.结论 动脉内溶检时间窗是与多种因素密切相关的,仅以发病时间不超过6 h作为治疗标准是不够全面的,应当根据病情合理放宽溶栓的时间窗,最大限度降低患者的病残率,提高了患者的生活质量.

Analysis of therapeutic time window and the effecting factors in acute cerebral infarction treated with intraarterial thrombolysis

Objective To analyze the clinical efficacy of intra-arterial thrmbolysis for acute cerebral infarction and to discuss factors affecting the therapeutic time window. Methods Fifty-four patients with acute cerebral infarction were acknowleged by CT and angiography and the underwent selective intra-arterial thrombolysis with one group of 42 cases within 6 hours after onset and another 12 between 6 and 24 hours. Vessel recanalization rate and neurological function deficit were evaluated after the procedure. Results The efficacies for the two groups were 88.1% and 75.0% , with excellent rates of 71.4% and 50.0 %, recanalization rates of 69.0% and 50.0%, and median times of recanalization of 68 and 73 minutes, respectively. Conclusion The therapeutic time window of intra-arterial thrombolysis was closely related to multiple factors and the standard time for treatment. The 6 hours of onset as standardization does not reflect all patients' conditions, the therapeutic time window should be reasonably elongated based on different patient's illness so as to decrease the mortality and morbidity on the largest scale and to increase the patient's living quality.