急性脑梗死早期血管再通的临床研究  

作　　者：何锐[1] 张素平[1] 杜德坤[1] 王慕真[1] 邓婉青[1] 梁瑞华[1] 何丽婵[1] 

机构地区：[1]广州市红十字会医院神经内科,510220

出　　处：《当代医学》2008年第6期46-47,共2页Contemporary Medicine

摘　　要：目的探讨急性脑梗死早期血管再通的方法及其疗效、安全性。方法26例急性颈动脉系统脑梗死患者，男性15例，女11例，从发病距接受治疗时间为6h以内。分5组：1组动脉溶栓后遗有明显狭窄，同时予以支架治疗（4例）；2组动脉溶栓后血管未通（4例），术后药物治疗；3组动脉溶栓后血管完全再通（9例），术后药物治疗；4组动脉溶栓后血管部分再通（5例），术后药物治疗；5组机械溶栓后放置支架（4例）。比较各组再通率、NHISS评分、死亡率。结果血管完全再通者临床症状改善明显，HIHSS评分明显改善。其中以动脉溶栓联合血管内支架成形术血管再通率最高，无死亡。结论急性缺血性脑血管病的治疗关键是使闭塞的血管尽早再开通动脉溶栓联合血管内支架成形术疗效较好且安全。Objective To evaluate the method efficacy and safety in early stage of patients with acute cerebral infarction. Methods 26 patients（15 males and 11 females） with acute cerebral infarction, caused by internal carotid artery system within 6 hours after symptoms onset were divided into five group.Patients in Group 1,2,3,4 were treated with intraarterial thrombolysis.Patients in group 1（4cases）were embedded bracket because of severe arterys stenosis. There was no recanaligation in patients of group2（4case）. Patients in group3（9cases） were recanaligation completely. Patients in group4 （5cases） were recanaligation pastly. Patients in group5（5cases） were treated with percutaneous transluminal angioplasty.and bracket was embedded. All patient received the same drug therapy. Recanaligation rate, NIHSS score and mortality rate were compared in 5 groups. Results Clinical symptoms were improved and NIHSS score were high in patients with recanaligation. Recanaligation rate in group 1 were highest. No patient died in group1. Conclusion The key of treatment in patient with acute cerebral infarction was recanaligation as early as possible. Intraarterial thrombolysis with percutaneous transluminal angioplasty is a better and safe therapy.

关 键 词：急性脑梗死 血管再通 动脉溶栓 血管内成形术 

分 类 号：R743.33[医药卫生—神经病学与精神病学]