双向局部动脉内溶栓治疗12例急性基底动脉梗塞的临床报告  

Bilateral local intra-arterial thrombolysis therapy of acute basilar artery occlusion:report of 12 cases

作　　者：王玉凯[1] 罗绍辉[1] 章成国[1] 邓其峻[1] 孙炽津[1] 张虹桥[1] 黄才东[1] 李国德[1] 邵燕[1] 

机构地区：[1]广东省佛山市第一人民医院神经科,神经介入诊疗中心,528000

出　　处：《中华神经医学杂志》2006年第8期848-850,共3页Chinese Journal of Neuromedicine

基　　金：佛山市科技局立项课题(200409)

摘　　要：目的观察并探讨局部动脉内溶栓治疗急性基底动脉梗塞的临床疗效和方法。方法12例临床确诊病人均行DSA全脑血管造影后,在微导丝导引下,将2．7F微导管送至血栓部位,并穿透血栓,总量50～100万U尿激酶分次在血栓的远端和近端注射进行双向溶栓。分别于术前、术后1d、术后14 d和术后28 d行美国国立卫生研究院卒中量表(NIHSS)评分。应用简明统计10．1软件进行单因素重复测量方差分析,并应用Dunnett t(t_D)检验对溶栓后各时间组评分和溶栓前评分进行两两比较。结果分析各时间点NIHSS评分结果发现,术后14 d和28 d组与术前组比较有显著性差异(P＜0．05,P＜0．01)；术后1 d组和术前组比较无显著性差异(P＞0．05)。结论双向局部动脉内溶栓治疗急性基底动脉梗塞是一种安全有效的方法,远期疗效好。Objective To observe and discuss the clinical effects and skills of local intra-arterial thrombolysis （LIT） therapy for acute basilar artery occlusion. Methods After cerebral angiography of the 12 cases of acute basilar artery occlusion, 0.5-1 million IU urokinase were injected at both sites of the thrombus after mechanical breaking through thrombus by 2.7F micro-catheter. All patients were evaluated by national institutes of health stroke scale （NIHSS） before the operation and 1 h, 2 and 4 weeks after the operation. Concise statistics 10.1 software was used to process the data with ANOVA for single factor repeated measures. Results There was no difference in the NIHSS scores between pre-thrombolysis and 1 d post-thrombolysis （P〉0.05）. The NIHSS scores of 2 and 4 weeks after thrombolysis were markedly decreased compared with the pre-thrombolysis or 1 d post-thrombolysis （P〈0.01）. Conclusion Bilateral LIT after mechanical breaking through the thrombus is a greatly effective and safe therapy for acute basilar artery occlusion, especially the long-term effects after thrombolysis will be better than the short-term.

关 键 词：缺血性脑血管病 动脉内溶栓 双向 

分 类 号：R743[医药卫生—神经病学与精神病学]