多模式CT指导下动脉溶栓术对急性脑梗死的治疗研究  

Multimode CT guided artery thrombolytic therapy in treatment of acute cerebral infarction

作　　者：马海 陈康宁[2] 任亚静 刘连锋 

机构地区：[1]中铁二十局中心医院神经内科,陕西咸阳712000 [2]第三军医大学西南医院神经内科,重庆400038

出　　处：《第三军医大学学报》2012年第21期2188-2190,共3页Journal of Third Military Medical University

基　　金：陕西省科学技术研究发展计划(2011K12-28)~~

摘　　要：目的观察多模式CT指导下的动脉内rt-PA接触溶栓的疗效。方法 2010年6月至2012年6月于中铁二十局中心医院神经内科就诊的急性缺血性卒中患者,经多模式CT筛选出符合溶栓的患者32例。其中男性22例,女性10例。年龄39～73岁,平均64岁。分为<3 h组及3～6 h组。记录溶栓前后的美国国立卫生研究院卒中量表(nationalinstitute of health stroke scale,NIHSS)、改良蓝金评分(modified rankin scale,MRS)及巴塞尔指数(barthel index,BI)。结果32例样本中26例(81.3%)患者溶栓治疗有效,23例(71.9%)临床结局良好,16例(50.0%)血管完全再通,症状性出血1例(3.1%)。溶栓前后NIHSS、MRS及BI明显改善,<3 h及3～6 h组溶栓安全性无显著差异(P>0.05)。结论多模式CT指导的动脉溶栓术治疗急性缺血性卒中是一种有效可行的方法。Objective To investigate the efficiency of multimode CT to guide intra-arterial thrombolytic therapy with recombinant tissue plasminogen activator （rt-PA）. Methods From June 2010 to June 2012, the patients within 6 h after stroke who visited our department were recruited, and evaluated by multimode CT scanning. There were 32 chosen patients eligible to receive intra-arterial thrombolytic therapy with rt-PA. They were 22 males and 10 females, with an age of 39 to 73 （mean 64）. They were divided into 2 groups, within 〈3 h group and 3 to 6 h group according to the time after onset of ischemic stroke. Their NIH stroke scale （ NIHSS）, modified Rankin score （mRS） , and Barthel indexes were recorded before and after intra-arterial thrombolytic therapy. Results After rt-PA treatment, 26 of 32 （81.3%） patients obtained sound outcome of thrombolytic therapy. Favorable outcome was obtained in 71.9% patients （23/32）. Sixteen patients （50%） had recanali- zation in the occluded arteries after rt-PA treatment. There was 1 patient （3.1% ） having symptomatic intracra- nial hemorrhage （ICH） in the cohort of patients. NIHSS, mRS and BI score was improved after thrombolytic therapy. There was no significant difference between 2 groups in safety of thrombolytic therapy. Conclusion Multimode CT evaluation in the rt-PA therapy is an useful tool to select eligible patients after acute ischemic stroke for intra-arterial thrombolytic therapy.

关 键 词：脑梗死 动脉溶栓术 头颅CT 

分 类 号：R741.05[医药卫生—神经病学与精神病学] R743.33[医药卫生—临床医学]