动脉内接触性溶栓治疗58例急性缺血性脑卒中  

The validity and security of intra-arterial contact thrombolytic therapy in 58 cases of acute ischemic stroke

作　　者：李建军[1] 那世杰[2] 杨咏波[2] 黄玉杰[2] 王斌[2] 

机构地区：[1]天长市人民医院神经内科,239300 [2]江苏省南京市鼓楼医院神经内科,南京210008

出　　处：《安徽医学》2010年第5期448-451,共4页Anhui Medical Journal

摘　　要：目的探讨急性缺血性脑卒中动脉内接触性溶栓治疗的安全性和有效性。方法对58例急性缺血性脑卒中在起病2.5～14h内进行尿激酶超选择性动脉内接触性溶栓,尿激酶用量25万～125万U(平均75万U)。结果 58例脑血管造影发现血栓闭塞51例,溶栓后成功再通37例。溶栓后发现3例血管狭窄明显,行球囊扩张,支架置入术。无血栓闭塞7例。临床症状完全恢复正常21例,明显好转17例,死亡2例。并发脑出血2例,上消化道出血8例。结论超选择动脉内接触性溶栓可使血栓局部迅速达到较高的血药浓度,疗效好,见效快,用药总量小,并发症少。Objective To discuss the validity and security of intra - arterial contact thrombolytie therapy in acute ischemic stroke patients. Methods 58 Patients were treated with intra - arterial thrombolysis using urokinase 25 - 125 × 104 ∪ （ median dose,75×104 ∪ ） within 2.5 - 14 hours after the onset of acute ischemic stroke. Results Angiography showed occlusion of the cerebral artery in 51 patients among 58 patients. After intra - arterial treatment with urokinase, successful reeanalization was observed in 37 among 51 patients. Re - stenosis was found in 3 patients, Whom were given stent therapy ; two patients died, and cerebral hemorrhage happened to 2 patients. Conclusion The super selective intra arterial thrombolytic therapy which can make higher thrombolytic drug concentration in local thrombus rapidly is more effective and safety.

关 键 词：脑卒中 动脉内溶栓 支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]