超选插管灌注溶栓药治疗视网膜中央动脉阻塞

目的观察导管介入眼动脉灌注尿激酶（urokinase）与静脉滴注尿激酶治疗视网膜中央动脉阻塞(CRAO)的效果及对全身的影响。方法超选插管至眼动脉灌注尿激酶患者6例，静脉滴注尿激酶溶栓患者7例，经荧光素眼底血管造影（FFA）判断动脉再通情况，同时作血液生化检查观察其对全身的影响。结果溶栓治疗次日插管组6例患者中有5例完全再通，1例部分再通，完全再通率达83.33％，而静脉组的7例患者中有3例完全再通，2例部分再通，2例不通，完全再通率42.86％，相差显著。插管组给药后血液中凝血系统指标无明显改变，与静脉给药组相比差异有统计学意义。结论导管介入眼动脉灌注尿激酶溶栓治疗效果较好，对全身影响小。治疗后的视力提高与阻塞时间有关，提示发病后应及早进行治疗。(中华眼底病杂志,2005,21:16-19)

Thrombolysis infusion via microcatheter treating central retinal artery occlusion

Objective To investigate the therapeutic effects of thrombolysis infusion via microcatheter on the treatment of central retinal artery occlusion(CRAO). Methods Urokinase (UK) was directly infused via ophthalmic artery (OA) by microcatheter (6 patients) or via intravenous (7 patients) to dissolve the thrombus. The patency of the artery was evaluated by fundus fluorescein angiography (FFA), and the effect of fibrinolytic activity on the systemic changes was observed by blood biochemical examination simultaneously. Results In 6 patients in the microcatheter group, 5 had completely and 1 had partly reopened OA on the morrow of UK infusion with the patency rate of 83.33%, while in 7 patients in vein group, 3 completely reopened, 2 partly reopened and 2 obstructed OA were found with the patency rate of 42.86%. The difference between the two groups was significant. No obvious change of index of blood coagulation system was found in catheter group, which had great disparity compared with the vein group. Conclusion Urokinase infusion via microcatheter in CRAO has better therapeutic impact and smaller effect on systemic action.