小脑前下动脉内灌注尿激酶治疗血管性突发性耳聋的疗效观察  

Efficacy of anterior inferior cerebellar artery infusion of urokinase in sudden vascular deafness

作　　者：程立山[1] 高朋杰[2] 宋宏杉 杜庆 陈晶[1] 郭柳彩 宋亚彬 冯俊强 张立志 

机构地区：[1]黑龙江省大庆油田总医院集团龙南医院、齐齐哈尔医学院第五附属医院神经内科,163453 [2]黑龙江省大庆油田总医院集团油田总医院口腔内科

出　　处：《中国现代神经疾病杂志》2010年第2期225-229,共5页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的观察经微导管超选择小脑前下动脉尿激酶溶栓治疗血管性突发性耳聋之疗效。方法 74例血管性突发性耳聋患者随机接受动脉或静脉溶栓治疗,手术后辅助低分子肝素(0.40 ml)和阿司匹林(100 mg)抗血小板聚集,分别于治疗后第1、3、6和10天复查电测听,以判定疗效。结果治疗第10天时,动脉溶栓治疗组患者治疗总有效率达84.21%(32/38),静脉溶栓治疗组为58.33%(21/36),两组比较差异有统计学意义(x^2=6.091,P=0.014)。两组溶栓治疗后不同观察时间点电测听结果比较,动脉溶栓治疗组显著优于静脉溶栓治疗组,差异有统计学意义(均P<0.01)。结论超选择经动脉予以尿激酶可能是治疗血管性突发性耳聋的有效方法。Objective To observe the efficacy of superselective trans-microcatheter intra-anterior inferior cerebellar artery thrombolytic therapy with urokinase for patients with sudden vascular deafness. Methods Seventy- four cases of sudden vascular deafness were randomly treated by transarterial or transvenous urokinase thrombolytic therapy. After thrombolysis, low molecular weight heparin subcutaneous injection of 0.40 ml （2 times/d） and aspirin 100 mg oral （1 time/d） were given continuously for 7 days. Electric audiometry was performed at day 1, 3, 6, 10 to assess the efficacy. Results At day 10, the total effective rate of patients given with transarterial thrombolysis （intra-arterial group） was 84.21% （32/38）, and the patients given with transvenous thrombolysis （intra-venous group） was 58.33% （21/36）, the difference between two groups was significant （X2 = 6.091, P = 0.014）. The results of electric audiometry at different time points in intra-arterial group were all better than those in intra-vcnous group, the differences were all significant （P 〈 0.01, for all）. Conclusion Superselective intra-arterial urokinase thrombolysis is probably an effective therapy for sudden vascular deafness.

关 键 词：听觉丧失 突发性 血栓溶解疗法 输注 动脉内 尿纤溶酶原激活物 

分 类 号：R764[医药卫生—耳鼻咽喉科]