动静脉溶栓治疗早期脑梗塞的对比研究  

Comparative study of treatment for acute cerebral infarction with intraarterial and intravenous thrombolysis

作　　者：温天明[1] 饶萍[1] 张洪良[1] 贾映海[1] 刘健[1] 周莉[1] 蔡德成[1] 唐宇红[1] 郭文莉[1] 

机构地区：[1]成都市第一人民医院神经科,四川成都610016

出　　处：《中华神经外科疾病研究杂志》2007年第2期118-121,共4页Chinese Journal of Neurosurgical Disease Research

基　　金：成都市卫生局基金资助项目(1999-01)

摘　　要：目的探索早期脑梗塞的有效疗法。方法选择发病6h内脑梗塞患者93例,随机分为动脉组(32例)和静脉组(61例)。除一般治疗外,静脉组予以尿激酶25万U/d静脉滴注,连续7d。动脉组经股动脉穿刺,将多孔微导管插入血栓,按1万U/min注入尿激酶,每使用25万U即测凝血指标并行血管造影,血管开通后,再注入25万U以溶解迁徙性血栓。结果两组3个月后疗效显示,动脉组有效率为87.5%,优于静脉组的60.65%(P<0.05);日常生活能力评价动脉组亦优于静脉组(P<0.05)。结论采用动脉溶栓治疗早期脑梗塞的疗效优于静脉溶栓。Objective To investigate the effective therapy for acute cerebral infarct. Methods A total of 93 patients suffering from infarction within 6 h were randomly divided into two groups： the intraarterial thrombolytic （IAT） group （n = 32） and the intravenous thrombolytic （IVT） group （n =61 ）. In the IVT group, the patients were treated with a daily dose of 250 000 U urokinase for 7 d. In the IAT group, urokinase was administered with a dose of 10 000 U/min via microcatheter at the site of the thrombus by superselective arterial catheterazition until recanalization, and then additional 250 000 U urokinase was injected in order to dissolve the migrating thrombus. R.esults The total effective rates examined 3 months after the stroke onset were significantly different （P 〈0.05）between the IAT group （28 cases, 87.5%） and the IVT group （37 case, 60.65%）. The ability of daily living activities in the IAT group was significantly higher than that in IVT group （P 〈 0. 05 ）. Conclusion Intraarterial thrombolytic with urokinase in the treatment of acute cerebral infarction has better clinical effect.

关 键 词：脑梗塞 溶栓 

分 类 号：R743.33[医药卫生—神经病学与精神病学]