动脉溶栓治疗基底动脉闭塞的临床疗效观察  

Clinical efficacy of intra-arterial thrombolsis for basflar artery occlusion

作　　者：陶华[1] 李慎茂[1] 朱凤水[1] 赵慧玭[1] 许研杰[1] 

机构地区：[1]首都医科大学北京宣武医院介入诊断治疗中心 ,100053

出　　处：《中华放射学杂志》2009年第8期849-852,共4页Chinese Journal of Radiology

摘　　要：目的探讨动脉溶栓治疗基底动脉闭塞的治疗效果及其影响因素。方法回顾性分析33例基底动脉闭塞经动脉溶栓治疗的患者资料，年龄28～71岁，平均（56±11岁）；其中男25例、女8例；动脉溶栓疗效评价参考格拉斯哥（GOS）预后评分，1～3分为预后不良，4～5分为预后良好。先根据出院病历评价患者出院时的短期疗效（住院期间疗效），然后通过电话随访评价患者术后1年的长期疗效。采用确切概率法比较预后良好和预后不良患者性别、年龄、发病至溶栓时间及头晕、眼球震颤、昏迷等症状和双侧Babinski征、闭塞部位、血管再通、血管成形和成形种类等指标之间的差别，以P〈0．05为差异有统计学意义。结果短期疗效评价时间（患者住院时间）为2—63d，平均（214-16）d，预后良好18例，预后不良15例（包括死亡3例）；血管再通良好21例；双侧Babinski征（＋）19例。在预后良好和不良患者，双侧Babinski征（＋）、血管再通良好、昏迷患者例数差异有统计学意义（P均〈0．05）。支架成形患者较球囊成形患者预后好，差异有统计学意义（P〈0．05）。预后良好和不良患者的年龄、性别、发病至溶栓时间间隔差异无统计学意义。长期随访时间1年，失访9例，预后良好15例，预后不良6例（包括死亡4例）。结论动脉溶栓治疗能够有效改善基底动脉闭塞患者的预后。Objective To evaluate the efficacy and influence of intra-arterial thrombolysis for basilar artery occlusion. Methods Thirty-three consecutive cases of basilar artery occlusion treated by intra-arterial thrombolysis were retrospectively reviewed. They were 25 males and 8 females aged from 28 to 71 years old（average： 56 ± tl years）. The recovery was graded by Glasgow outcome scale, which 1 to 3 point is unfavorable and 4 to 5 is favorable. The short-term follow-up was performed referring to the medical record at the time of discharge and the long-term follow-up was performed by telephone. The differences between the favorable and unfavorable, including sex, age, time to thrombolysis, dizziness, nystagmus, coma, bilateral babinski syndrome, occlusive part, revascularization, angioplasty and its type, were compared by Fisher exact test where P 〈 0.05 was significant. Results The short-term follow-up was evaluated during the admission （2 to 63 days, 21 ± 16 days）. Eighteen cases were favorable and 15 cases were unfavorable and 3 cases died. Twenty one cases showed revascularization and 19 eases showed bilateral positive Babinski sign. The positive Babinski sign, revascularization and coma had significant difference between the favorable and unfavorable （ P 〈 0. 05 ） . The sex, age, time to thrombolysis between the favorable and unfavorable showed no statistical difference. The long-term follow-up were performed after 1 year and 9 cases missed. 15 of them were favorable and 6 were unfavorable （4 cases died）. Conclusion The intra-arterial thrombolysis could improved the prognosis of basilar artery occlusion.

关 键 词：血栓溶解疗法 椎底动脉供血不足 放射学 介入性 

分 类 号：R686[医药卫生—骨科学]