动脉内接触性溶栓及机械碎栓治疗急性脑梗死效果观察  

Effect of Intra-arterial Thrombolysis Combined with Mechanical Thrombectomy in Treatment of Patients with Acute Cerebral Infarction

作　　者：杜彦龙[1] 魏爱英[2] 王国芳[2] 朱青峰[2] 

机构地区：[1]山西医科大学研究生院,太原030001 [2]解放军264医院神经外科,太原030001

出　　处：《解放军医药杂志》2014年第9期26-29,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：2012年山西省科技攻关课题(20120313018-2)

摘　　要：目的观察超选择性动脉内接触性溶栓及机械碎栓治疗急性脑梗死临床效果。方法对2006年1月—2014年1月收治的时间窗内急性脑梗死28例给予超选择性动脉内接触性溶栓及机械碎栓,同时给予扩容、抗血小板等治疗,评价治疗后即刻血管再通率、术后1 h、2周、3个月美国国立卫生研究院脑卒中量表(NIHSS)、日常活动量表(ADL)评分情况。结果本组动脉内接触性溶栓后即刻血管完全再通率为75%,部分再通率为25%,4例血管再通后残留狭窄>80%,给予支架置入术;除1例死于中枢性呼吸衰竭外,其余27例术后1 h、2周、3个月NIHSS、ADL评分较治疗前改善(P<0.05)。结论动脉内接触性溶栓结合机械碎栓治疗时间窗内急性脑梗死安全、有效。Objective To observe the clinical effect of super selective intra-arterial thrombolysis combined with mechanical thrombectomy in treatment of acute cerebral infarction. Methods A total of 28 patients with acute cerebral infarction during January 2006 and January 2014 underwent super selective intra-arterial thrombolysis combined with me-chanical thrombectomy treatment,and the conventional treatments such as expansion and antiplatelet treatments were giv-en at the same time. The immediately postsurgical revascularization rate,and the scores of the National Institutes of Health stroke scale（ NIHSS）and activity of daily living（ ADL）on 1 h,2 weeks and 3 months after the treatment were evaluated. Results After the treatment,the complete recanalization rate was 75%,and partial recanalization was 25%, the residual stenosis was more than 80% in 4 patients after recanalization,and stenting insertion was performed at the same time;the scores of NIHSS and ADL on 1 h,2 weeks and 3 months after the operation in the 27 patients were im-proved（P〈0. 05）,except 1 patient who died of central respiratory failure. Conclusion The intra-arterial thrombolysis combined with mechanical thrombectomy in treatment of acute cerebral infarction is safe and effective.

关 键 词：脑梗死 机械溶栓 尿激酶 

分 类 号：R743.33[医药卫生—神经病学与精神病学]