脑血管造影血流冲击对急性脑梗死的治疗作用  

The effect of bloodstream impact during cerebral angiography on early acute cerebral infarction

作　　者：张桂莲[1] 张茹[1] 王虎清[1] 吴海琴[1] 孙宏[1] 展淑琴[1] 杨新利[1] 祁晓江[2] 

机构地区：[1]西安交通大学医学院第二附属医院神经内科,西安710004 [2]西安交通大学医学院第二附属医院放射科,西安710004

出　　处：《陕西医学杂志》2011年第11期1486-1489,共4页Shaanxi Medical Journal

基　　金：西安交通大学医学院第二附属医院2009年新技术资助项目

摘　　要：目的:观察脑血管造影血流动力学改变对早期急性脑梗死患者临床神经功能的影响。方法:对32例发病24h内的急性脑梗死患者进行急诊脑血管造影术,部分患者进行球囊扩张或支架置入术,分别采用NIHSS及CSS对患者进行术前及术后0.5h、6h、24h及48h临床神经功能缺损评分,观察患者临床病情变化。结果:28例(87.5%)的患者临床神经功能缺损评分在术后0.5h明显改善,NIHSS及CSS评分分别由术前的11.13±7.11分及23.12±4.36分降为5.32±4.31分及10.12±3.22分;18例(56.25%)单纯进行脑血管造影者术前及术后6h神经功能缺损评分基本一致,无明显统计学意义。32例患者术后0.5h、6h两种临床神经功能缺损评分均明显下降,术后24h评分明显回升,但仍明显低于术前。结论:脑血管造影术能明显改善早期急性脑梗死患者的病情,合理的高压注射血流冲击有可能成为早期急性脑梗死的治疗手段之一。Objective：To observe the effect of bloodstream dynamic during cerebral angiography on the clinical neurologic impairment of the patients with early acute cerebral infraction.Methods： Cerebral angiography was performed to 32 acute cerebral infarction patients within 24h after onset and the clinical neurologic impairment was assessed according to the National Institute of health stroke scale（NIHSS） and Chinese stroke scale（CSS） before the operation and 0.5h,6h,24h,48h after the operation respectively.Expansion or stenting was performed to some of the patients.Results：The clinical neurologic impairments in 28 patients（87.5% of the patients） improved remarkably at 0.5h after the operation comparing with that before the operation.The score of NIHHS and CSS before and after the operation decreased from 11.13 ± 7.11 and 23.12 ± 4.36 to 5.32 ± 4.31 and 10.12 ±3.22 respectively.The score of clinical neurologic impairment in 18 patients（56.25% of the patients） who were only performed cerebral angiography had no significant difference at 6h after the operation comparing with that before the operation.Both the score of NIHHS and CSS were lower at 0.5h and 6h after operation.The score at 24h after operation rose remarkably,but it was still lower than that before the operation in 32 patients.Conclusions： Cerebral angiography can improve the condition of patients with early cerebral infarction.Reasonable high pressure bloodstream impact may be a better treatment to early acute cerebral infarction.

关 键 词：脑梗塞/治疗 脑血管造影术 血流动力学 

分 类 号：R743.3[医药卫生—神经病学与精神病学]