急性缺血性脑中风早期局部动脉内溶栓

目的　评价局部动脉内溶栓在急性缺血性脑中风治疗中的作用。方法　 11例急性缺血性脑中风患者 ,采用局部动脉内灌注尿激酶 (UK)溶栓 ,所有病例均在发病 10h内接受治疗。入院时平均脑中风评分 (NIHS)为 18分。均为大脑中动脉 (MCA)闭塞。术后 3 0d用RankinScale(RS)标准评估疗效。结果　 7例 (63 .6% )闭塞获得完全再通 ,1例 (9% )部分再通后并发颅内出血。 3例(2 7.3 % )无效。术后 3 0d ,2例 (18.2 % )完全恢复 (RS 0～ 1分 ) ,5例 (4 5 .5 % )轻度神经功能障碍 (RS 2～ 3分 ) ,4例 (3 6.3 % )重度神经功能障碍 (RS 4～ 5分 ) ,无死亡。结论　早期 (6h内 )局部动脉内溶栓是治疗急性缺血性脑中风的有效方法

Early Local Intraarterial Thrombolysis for Treatment of Ischemic Acute Stroke

Objective To assess effect of early local intraarterial thrombolysis(ELIT)for treatment of acute stroke.Methods Eleven patients were treated with ELIT using urokinase(UK)within ten hours of ictus.The median national institusion of health stroke scale(NIHS)score at hospital admission was 18.All patients had occlusion of the middle cerebral artery(MCA).Outcome was assessed after treatment 30 days with rankin scale (RS) score. Results Seven of the eleven patients (63.6%) had complete recanalization;partial recanalization and intracranial hemorrhage was observed in one patient (9%);no recanalization in three patients (27.3%).After ELIT 30 days,2 patients (18.2%)recovered to RS score 0 or 1,5(45.5%) to score of 2 or 3,and 4(36.6%)to score of 4 or 5,not patient death.Conclusion ELIT is most efficacious in patients with MCA occlusion when treated within 6 hours.Successful MCA recanalization is associated with a better outcome.