急诊超选择动脉溶栓及经皮腔内血管成型术治疗脑梗死

目的：评价超选择动脉溶栓及经皮空内血管成形术（PTA）治疗急性脑梗死的临床疗效。方法：对30例急性脑梗死病人，经股动脉或颈动脉插管，用微导丝将微导管送至血管闭塞部位，注入尿激酶（UK）行溶栓治疗，对6例颅外段血管狭窄者，采用PTA消除，并注向罂粟碱扩张颅内血管，结果：颈内动脉闭塞10例，大脑中动脉16例，椎基动脉系统4例中，血管完全再通15例，部分再通12例，治疗3个月后日常生活能力指数（BI）评分：100分20例，75－95分6例，占86．67％，结论：早期超选择动脉溶栓配合PTA和罂粟碱可明显提高闭塞血管再通率，是目前治疗急性脑梗死有效的方法。

Combinselective intravascular thrombolysis and percutaneous transluminal angioplasty for acute ischemic stroke

Objective To evaluate the therapeutic effect of selective intraarterial thrombolysis (SIT) and percutaneous transluminal angioplasty (PTA) for acute ischemic stroke.Methods 30 cases of acute ischemic stroke had been included in this series.The microguidewire was made to reach the embolus,and then removed,and left the catheter in position.Then the thrombolysis therapy was performed by local intravascular infusion of urokinase at the site of occlusion.PTA was used to eliminate the stenosis in extracranial arterial in 6 cases,combined with infusion of papaverine.Results Among the 10 cases of occlusion of internal carotid artery,16 cases of occlusion of middle cerebral artery,and 4 cases of occlusion of vertebralis artery,15 cases were completey recanalized,and 12 cases were partially recanalized.Three months after treatment the recovery rate of neurologic deficits was 86.67%(26/30).Conclusion SIT combined with PTA and papaverine is an effective method in the treatment of acute ischemic stroke.