急性脑梗死患者的动脉内介入治疗  

The study of intra-arterial interventional treatment in acute cerebral infarction.

作　　者：贾志安[1] 张海欣[2] 顾俊琴[3] 赵淑芹[4] 胡磊[2] 

机构地区：[1]保定市新市区医院内科,河北保定071051 [2]保定市第二医院神经内科,河北保定071051 [3]保定市儿童医院内五科,河北保定071051 [4]河北省职工医学院附属医院内科,河北保定071051

出　　处：《中国实用内科杂志》2007年第S1期165-168,共4页Chinese Journal of Practical Internal Medicine

摘　　要：目的研究急性脑梗死患者的动脉内介入治疗(选择性动脉内溶栓)的方法及疗效。方法选择2000年1月至2006年12月保定市第二医院神经内科106例急性脑梗死患者,分为选择性动脉内溶栓组(SIAF组)和静脉溶栓组(IVF 组);SIAF 组采用改良 Seldinger 技术,选择性进入闭死动脉,40 min 内泵入尿激酶500 kU和生理盐水60 mL,随时做造影了解动脉是否通畅,不通者再泵入尿激酶30 kU,只要闭死动脉再通,即停止泵入尿激酶。IVF 组40 min 内静脉滴入尿激酶1000 kU 和生理盐水150 mL,不通者再滴入尿激酶30 kU,余同上。结果溶栓后再通者 SIAF 组48例,IVF 组30例,两组比较差异有显著性意义(P<0.01);并发出血者 SIAF 组5例,IVF 组13例,两组比较差异有显著性意义(P<0.01);病情好转者 SIAF 组49例,IVF 组33例;死亡 SIAF 组3例,IVF 组9例,两组比较差异有显著性意义(P<0.01)。结论急性脑梗死患者动脉内介入治疗,既可超早期诊断又可超早期治疗,效果明显。Objective To study the method and therapeutic results of intra-arterial interventional treatment (selective intra-arterial fibrinolysis) in acute cerebral infarction(ACl).Methods A total of 106 patients with ACI are divided into two groups:selective intra-arterial fibrinolytic therapy group(SIAF),intra-venously thrombolysis group(IVF);SIAF is selective entered into the obliterative artery with improved Seldinger's technich,pumped urokinase(UK) in a dose of 500 000 i.u.in NS.60ml within 40 minutes;arteriography is done all the time to know if the obliterative artery is unobstruct- ed,if it remains obstructe,then pumps 300 000 i.u.of UK,as long as it unobstructed,the treatment is finished at once; IVF is injected 1000 000 i.u.of UK in NS.150 mL by intravenous drip within 40 minutes,others like SIAF.Results The artery is disobliteration after thrombolysis,48 patients in SIAF,30 patients in IVF,P<0.01;complicated hemorrhage 4 patients in SIAF,13 patients in IVF,P<0.01;the patients' condition is good,49 in SIAF,33 in IVF,P<0.01;fatal ca- ses 3 in SIAF,9 in IVF,P<0.01.Conclusion Selective intra-arterial fibrinolysis is a effective method of treating ACI,either extra-early diagnosis or extra-early treatment,the response to treatment is dramatic.

关 键 词：脑梗死 急性 动脉内介入 选择性动脉内溶拴 效果 

分 类 号：R743.33[医药卫生—神经病学与精神病学]