急性脑梗死超早期应用尿激酶动脉溶栓治疗四例

目的评价急性脑梗死超早期应用尿激酶动脉溶栓的疗效及安全性。方法应用尿激酶动脉溶栓治疗4例急性脑梗死患者,分析溶栓时间窗、尿激酶剂量、责任供血动脉再通情况与转归的关系等。结果例2大脑中动脉溶栓后症状完全缓解;例4颈内动脉溶栓后颈内动脉完全再通,但有皮层支梗死;例1、3大脑中动脉溶栓后部分再通。本文4例患者溶栓后2周神经功能缺损评分明显降低。结论急性脑梗死超早期应用尿激酶动脉溶栓治疗能明显提高责任供血动脉再通率,改善患者预后。动脉溶栓对大、中动脉急性闭塞性脑梗死患者疗效显著,对穿支动脉急性闭塞脑梗死患者疗效欠佳,有待进一步随机、双盲、大样本证实。

Treatment of hyperacute cerebral infraction with intra-arterial thrombolysis using urokinase in four patients

Objective To evaluate the clinical efficacy and safety of intra-arterial thrombolysis using urokinase in patients with hyperacute cerebral infraction.Methods 4 patients of acute cerebral infraction were treated with intra-arterial thrombolysis using urokinase.We analysis of the relationship among thrombolysis time window,urokinase dose,responsible vessel and prognosis.Results After intra-arterial thrombolysis,middle cerebral artery of case 2 was complete recanalization;internal carotid artery of case 4 total recanalization,but having a cortex infarction;case 1 and 3 partial recanalization.In this paper total 4 patients,the scores of neural function defect decreased significantly after 2 weeks.Conclusion Intra-arterial thrombolysis with urokinase can significantly improve arterial recanalization rate and improve the prognosis of patients.Arterial thrombolysis for acute occlusion of large artery in patients has obvious curative effect,but the perforator artery in acute occlusion of cerebral infarction patients has poor treatment outcome.So we need a large sample,randomized and control study to confirm.