尿激酶与替罗非班超选择注射在颅内动脉瘤栓塞术治疗中的效果及安全性分析  

Analysis of the efficacy and safety of urokinase and tirofiban superselective injection in the treatment of intracranial aneurysm embolization

作　　者：尹志钧 蔡舒[1] 李平雨[1] 周忠义[1] 黄柳兰 YIN Zhi-jun;CAI Shu;LI Ping-yu(Dongguan Houjie Hospital,Dongguan 523000,China)

机构地区：[1]东莞市厚街医院,广东东莞523000

出　　处：《中国处方药》2021年第6期63-65,共3页Journal of China Prescription Drug

摘　　要：目的研究尿激酶与替罗非班超选择注射在颅内动脉瘤栓塞术治疗中的效果及安全性。方法选择2017年1月~2020年3月期间行颅内动脉瘤栓塞术时发生急性血栓的62例患者为研究对象,按治疗方案划分为观察组(n=31)与对照组(n=31)。观察组采用经溶栓导管动脉超选择注射替罗非班治疗方案,对照组采用经溶栓导管动脉超选择注射尿激酶治疗方案,对两组患者治疗效果、治疗前后凝血功能(APTT)、血小板计数(PLT)、血管再通时间、并发症发生情况及预后情况进行比较分析。结果观察组治疗总有效率比对照组更高(P<0.05)。治疗后3 d、7 d两组患者APTT水平较治疗前均略微上升,PLT水平略微下降,但差异较小(P>0.05),组间对比差异无统计学意义(P>0.05)。观察组血管再通时间比对照组更短,术后7 d内复查CT脑出血、迟发性出血及脑梗死发生率均比对照组低(P<0.05);两组患者预后情况对比差异不明显(P>0.05)。结论针对颅内动脉瘤栓塞术治疗选用替罗非班超选择注射效果优于尿激酶,可缩短血管再通时间,减速术后并发症发生情况,确保手术的安全有效性。Objective To study the efficacy and safety of urokinase and tirofiban superselective injection in the treatment of intracranial aneurysm embolization.Methods Sixty-two patients with acute thrombosis during intracranial aneurysm embolization from January 2017 to March 2020 were selected as the research objects.According to the treatment plan,they were divided into the observation group(n=31)and the control group(n=31)).The observation group was treated with a thrombolytic catheter-arterial super-selective injection of tirofiban,and the control group was treated with a thrombolytic catheter-arterial super-selective injection of urokinase.The efficacy,APTT,PLT,vascular recanalization time,complications and prognosis were compared and analyzed.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).3 and 7 days after treatment,the APTT levels of the two groups of patients increased slightly compared to before treatment,and the PLT levels decreased slightly,but the difference was small(P>0.05),and the difference between the groups was not statistically significant(P>0.05).The blood vessel recanalization time of the observation group was shorter than that of the control group.The incidence of CT cerebral hemorrhage,delayed hemorrhage and cerebral infarction within 7 days after operation was lower than that of the control group(P<0.05);the difference in the prognosis of the two groups was not obviously different.(P>0.05).Conclusion Tirofeban is better than urokinase in the treatment of intracranial aneurysm embolization,which can shorten the time of vascular recanalization,reduce the incidence of postoperative complications,ensure the safety and effectiveness of the operation.

关 键 词：颅内动脉瘤栓塞术 急性血栓形成 超选择注射 尿激酶 替罗非班 安全性 

分 类 号：R651.1[医药卫生—外科学]