静脉联合动脉双途径溶栓治疗超早期脑梗死的临床研究  

Clinical Study of Combined Intravenous and Intra-arterial Thrombolysis for Ultra-acute Cerebral Infarction

作　　者：王文明[1] 盛玉国[1] 李乃选[1] 刘庆新[1] 荆秀荣[1] 段新武[1] 许春胜[1] 王庆良[2] 

机构地区：[1]滨州医学院附属医院介入科,山东滨州256603 [2]山东大学齐鲁医院,山东济南250021

出　　处：《中外医疗》2008年第20期12-13,共2页China & Foreign Medical Treatment

基　　金：山东省优秀中青年科学家奖励基金(03-BS041)

摘　　要：目的探讨动静脉联合溶栓治疗超早期脑梗死的临床疗效及安全性。方法将81例发病在6h内的超早期脑梗死患者随机分为两组:静脉联合动脉溶栓组(组Ⅰ)共46例;超选择性动脉溶栓组(组Ⅱ)35例。联合组先静脉滴注尿激酶1万U/kg,再选择病变动脉给尿激酶0.5万U/kg;动脉组单纯病变动脉灌注尿激酶1万U/kg。术前及术后24h、3d、30d采用欧洲卒中量表(ESS)评价神经缺损功能和Barthel指数(BI)评价日常生活能力,观察疗效和不良反应。结果溶栓24h、3d后ESS评分组Ⅰ为83±24,88±26;组Ⅱ为77±29,81±24;溶栓后3d、30dBI指数评分组Ⅰ为71.5±25.9,82.5±27;组Ⅱ为61.5±22.3,72.0±31.6,治疗后有效率:组Ⅰ为86.7%,组Ⅱ为77.1%,两组比较差异有显著性(P<0.05)。两组分别有3例和2例患者溶栓后CT显示颅内出血征象,无明显差异。结论起病6h内,动静脉联合溶栓提高急性脑梗死的溶栓疗效,安全性与动脉溶栓相似。Objective To evaluate the efficacy and safety of combined intravenous and intra-arterial thrombolysis for ultra- acute cerebral infarction.Methods 81 patients with acute ischemic stroke of within 6 hours after onset were randomly assigned into two groups, groupⅠ including 46 patients with combined intravenous and intra-arterial thrombolysis and group Ⅱ 35 patients with intra-arterial thrombolysis alone.In groupⅠ,10 000U/kg urokinase were intravenously administered following 5000U/kg urokinase given intra-ar...

关 键 词：卒中 尿激酶 脑梗死 溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]