机械辅助动脉内溶栓治疗急性缺血性脑卒中  

Mechanical auxiliary arterial thrombolytic therapy for the treatment of acute ischemic stroke

作　　者：王慧晓[1] 徐永康[1] 张剑平[1] 沈益金[1] 陆洲[1] 

机构地区：[1]鄞州宁波大学附属鄞州人民医院神经外科,315040

出　　处：《介入放射学杂志》2012年第8期664-667,共4页Journal of Interventional Radiology

基　　金：宁波市医学科技项目(2006058)

摘　　要：目的评估机械辅助动脉内尿激酶溶栓治疗缺血性脑卒中的临床疗效及安全性。方法 2007年1月至2010年10月对28例急性缺血性脑卒中患者,于发病时间在90～450 min行机械辅助动脉内尿激酶溶栓治疗。采用的机械辅助方法有导丝碎栓、导管抽吸取栓及支架应用等,术后统计血管再通率、出血并发症及3个月后改良Rankin量表(mRS)评分。结果 28例患者应用机械辅助溶栓成功再通血管23例,血管再通率为82.1%,平均血管再通时间为65.22 min,3个月后mRS评分均≤3分;5例血管再通无效者中2例死亡,1例mRS评分4分,2例mRS评分≤3分。血管再通组中,机械辅助溶栓并未增加出血并发症率。结论机械辅助溶栓治疗急性缺血性脑卒中安全有效,能减少尿激酶用量及血管再通时间,提高再通率。Objective To evaluate the clinical efficacy and safety of mechanical auxiliary arterial thrombolytic therapy in treating acute isehemic stroke. Methods During the period from Jan. 2007 to Oct. 2010 a total of 28 patients with acute ischemic stroke were treated in the hospital. Mechanical auxiliary arterial thrombolysis and intra-arterial infusion of urokinase was carried out, which was started within 90 - 450 minutes after the onset of the disease. The mechanical auxiliary thrombolysis means included cutting up of the thrombus with the guidewire, aspiration of the thrombus through the catheter, stent implantation, etc. Postoperative vascular recanalization rate, symptomatic as well as asymptomatic intracranial hemorrhage were recorded. Three months after the operation, modified Rankin Scale （mRS） score was calculated. Results Successful recanalization was achieved in 23 patients, with a reeanalization rate of 82.1%. The average time for obtaining vascular reopen was 65.22 minutes. Three months after the treatment, the mean mRS score was ≤ 3. Among the 5 cases who failed to respond to the treatment, death occurred in two, mRS score= 4 was seen in one, and mRS score ≤ 3 was seen in two. In successful recanalization patients, mechanical auxiliary arterial thrombolytie therapy did not increase the incidence of bleeding complications. Conclusion Mechanical auxiliary arterial thrombolytic therapy is safe and effective for the treatment of acute ischemic stroke. This technique can reduce the usual amount of urokinase, quicken the vascular recanalization and increase the recanalization rate.

关 键 词：急性缺血性脑卒中 机械辅助溶栓 支架 血管再通 

分 类 号：R743.3[医药卫生—神经病学与精神病学]