超声引导下颈动脉穿刺加压滴注尿激酶治疗急性脑梗死  

Treatment of acute cerebral infarction by UK pressor dripping through ultrasound-guided carotid puncture

作　　者：高贵留[1] 徐潮[1] 张彩玉[1] 马修云[1] 汤祎[1] 吕毅[1] 

机构地区：[1]青岛大学医学院附属威海医院,山东威海264200

出　　处：《山东医药》2009年第27期25-27,共3页Shandong Medical Journal

摘　　要：目的评估超声引导下颈动脉穿刺加压滴注尿激酶治疗急性脑梗死的疗效及安全性。方法对15例急性脑梗死患者行超声引导下颈动脉穿刺加压滴注尿激酶治疗,即通过超声显像明确患侧颈动脉解剖结构和颈内动脉位置,在超声引导下用套管针由病灶侧颈动脉穿刺后将稀释后的尿激酶100万U加压滴注,观察其疗效及不良反应。结果发病到溶栓治疗开始时间平均3.1h,溶栓治疗时间平均32min;3例因ICA出现不稳定斑块行CCA穿刺,余12例行ICA穿刺;与治疗前比较,治疗后颈内动脉超声血流速度等指标明显改善,斯堪的那维亚卒中量表(SSS)评分明显提高(P<0.01),改良Rankin量表(mRS)评分为优3例、良6例、一般1例、差5例、死亡3例;未发生明显严重并发症。结论超声引导下颈动脉穿刺加压滴注尿激酶治疗急性脑梗死可明显缩短发病至治疗时间,且近期疗效肯定、并发症少、操作简便;但本组病例数相对偏少,远期疗效有待于多中心大样本研究观察。Objective To explore the clinical effect and security of UK pressor dripping in the treatment of acute cerebral infarction（ACI）through ultrasound-guided carotid puncture.Methods Fifteen patients with ACI were treated with UK pressor dripping through ultrasound-guided carotid puncture.The anatomic structure and location of carotids were visualized by ultrasound,then 1000,000 U UK were injected into the carotid by pressor dripping.Then the clinical effect and complications were observed.Results The average time from attack to thrombolysis was 3.1hours,and the average treatment time was 32 minutes;3 cases were found vulnerable plaques in ICA and performed with CCA puncture,the other 15 cases were performed with ICA puncture.SSS score increased statistically（P〈0.01）after therapy.mRS score showed 3 cases of good outcome,6 cases of relatively good outcome,1 cases of generic outcome,5 cases of bad outcome,3 cases of death.No serious complications were found.Conclusions This method can shorten the pretreatment delay time and has the advantages of positive shorttime effect,few complications and easy operation;cases in this study is relatively few,long-term outcomes remain to be confirmed by further study.

关 键 词：超声引导 脑梗死 急性 尿激酶 颈动脉穿刺 溶栓 

分 类 号：R743.33[医药卫生—神经病学与精神病学]