机械碎栓、支架取栓联合动脉注射rt—PA治疗急性脑血管闭塞的疗效观察  

Superselective intracranial arterial thrombolysis with rt - PA, mechanical fragmentation and （or） solitairAB sent thrombectomy in patients with acute cerebral artery occlusion

作　　者：怀鹏[1] 史万超[1] 苏治国[1] 赵玉军[2] 刘晓智[1] 刘振林[1] 

机构地区：[1]天津市第五中心医院神经外科,300450 [2]天津市第五中心医院神经内科,300450

出　　处：《中华神经外科杂志》2012年第11期1116-1119,共4页Chinese Journal of Neurosurgery

基　　金：基金项目：天津市滨海新区卫生局联合攻关项目（2011BHKL002）;天津市塘沽区科委科技兴区项目（2011XQ13-08）

摘　　要：目的评价动脉途径给予rt—PA结合微导丝、微导管机械碎栓、SolitaireAB支架对急性脑血管闭塞的临床效果及安全性。方法回顾性分析2010年10月至2012年3月收治的42例应用rt—PA结合微导丝、微导管机械碎栓和（或）SolitaireAB支架治疗的急性脑血管闭塞患者的临床资料。结果42例患者闭塞脑血管完全或部分再通，再通率为100％；其中37例完全再通，完全再通率88％。术后1例发生基底节区脑出血，l例发生蛛网膜下腔出血，1例出现昏迷并持续高热，于术后8d死亡。9例（21％）经后期内科治疗后遗留不同程度的神经功能障碍。术前和术后不同时间NIHSS评分及ADL评分相比差异有统计学意义（P〈0．05）。结论对治疗时间窗内的急性脑血管闭塞患者，微导管、微导丝机械性碎栓和（或）SolitaireAB支架结合动脉内注射It—PA治疗是安全有效的。Objective To study the clinical effects and safety of the treatment in acute cerebral artery occlusion with superselective intracranial arterial thromblysis by rt - PA, mechanical fragmentation by microcatheter and microguid wire and （or） solitairAB sent thrombectomy. Methods 42 patients of acute cerebral artery occlusion were treated by superselective intracranial arterial thrombolysis, mechanical fragmengation and （or） solitairAB sent thrombectomy from October 2010 to March 2012 and the data were retrospectively reviewed. Results Occluded arteries of 42 patients were dredged totally or partialy, the recanalization rate or partial recanalization rate of blocked blood vessel was 100%, including 37 cases with total recanalization （88%）. After operation one case suffered from cerebral hemorrhage of basal ganglia, one subarachnoid hemorrhage, and one died of ardent fever after 8 days. 9 cases （21%） remained functional impairments to some extents after medical therapy. The ranks of NIHSS between preoperation and 1 week after operation were discrepant obviously. Conclusions Superselective intracrainal arterial thrombolysis by rt - PA and papaverine, mechanical fragmentation by microcagheter and micoguide wire and （or） solitairAB sent thrombectomy in patients of acute cerebral artery occlusion is a safe and an effective therapy within the right time.

关 键 词：机械碎栓 支架取栓 脑血管闭塞 动脉溶栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]