超早期动脉溶栓联合机械碎栓治疗颈内动脉系统脑梗死的临床探讨  

CLINICAL RESEARCH OF SUPER-EARLY ARTERIAL THROMBOLYSIS COMBINED WITH MECHANICAL THROMBECTOMY FOR ACUTE CAROTID SYSTEM CEREBRAL INFARCTION

作　　者：唐永刚[1] 齐立[1] 俸军林[1] 刘开祥[1] 谌艳芳[1] 廖小明[1] 

机构地区：[1]广西桂林医学院附属医院神经内科,桂林541001

出　　处：《广西医科大学学报》2012年第6期872-873,共2页Journal of Guangxi Medical University

基　　金：广西科学研究与技术开发计划项目(No.桂科攻10124001B-16)

摘　　要：目的:观察超早期动脉溶栓联合机械碎栓治疗颈内动脉系统脑梗死的安全性、可行性及疗效。方法:对13例发病4.5h以内的颈内动脉系统脑梗死患者实施选择性动脉内尿激酶溶栓联合机械碎栓治疗,其中颈内动脉闭塞4例,大脑中动脉闭塞9例,全组患者经头颅CT排除颅内出血及低密度病灶。结果:4例颈内动脉闭塞患者2例血管完全再通,1例部分再通,1例无变化,其中3例患者死亡,1例神经功能部分改善;9例大脑中动脉闭塞患者7例血管完全再通,2例部分再通,患者神经功能均明显改善。结论:选择性动脉内尿激酶溶栓联合机械碎栓治疗超早期颈内动脉系统脑梗死患者能使闭塞血管尽快开通,改善神经功能缺损,但疗效与血管闭塞部位相关。Objective： To observe the feasibility, safety and efficacy of super-earlyarterial thrombolysis com- bined with mechanical thrombectomy in the treatment of acute carotid system cerebral infarction. Methods： Thirteen patients with acute carotid system cerebral infarction including carotid artery occlusion （4 pa- tients）, middle cerebral artery occlusion （9 patients） were treated by intra-arterial thrombolysis with uro- kinase and mechanical fragmentation. All patients were within 4.5 hours from reporting symptoms to thrombolytic therapy and confirmed no cerebral hemorrhage by CT scan. Results： Among 4 patients with carotid artery occlusion, two were completely recovered, one was partially recovered, and one was not re- covered. Three patients died. One patient partially recovered. Among 9 patients with middle cerebral ar- tery occlusion, seven were completely recovered, and two was partially recovered. All patients significant recovered. Conclusion： For patients with acute carotid system cerebral infarction, highly selective local in- tra-arterial thrombolysis combined with mechanical fragmentation treatment can open blood clots safely and effectively, but the efficacy relates with the location of infarction.

关 键 词：脑梗死 颈内动脉 动脉溶栓 机械碎栓 

分 类 号：R743[医药卫生—神经病学与精神病学]