动脉内超选择性溶栓治疗急性缺血性脑梗死

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6h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(15．2％)，未通15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。31例溶通患者中良好、中残者20例(64.5％)，15例未溶通患者中良好、中残者4例(26．7％)，溶栓后脑出血6例(13％)。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率，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。

Intra-arterial superselective thrombolytic therapy for acute cerebral infarction

Objective To observe the efficacy and complication of intra-arterial superselectivethrombolysis using urokinase for acute ischemic stroke. Methods 46 patients of acute ischemic stroke within 6h from onset were treated by intra-arterial superselective thrombolytic therapy using urokinase. Results Complete recanalization just after thrombolysis were observed in 24 of the 46 patients(15. 2%), no recanalization in 15 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 31 (64. 5%) patients of complete/partial recanalization were good recovery or moderate disability, only 4 of the 15 (26. 7%) patients of no recanalization were good recovery or moderate disability. Conclusion Intra-arterial superselective thrombolysis can apparently improve the rate of recanalization and clinical outcome. It is an effective and relatively safe therapy in treatment of acute ischemic stroke.