摘要
目的观察选择性动脉溶栓治疗6h内急性颈内动脉闭塞患者的有效性和安全性。方法对8例急性颈内动脉闭塞患者行数字减影血管造影术(DSA)后,将溶栓微导管送入急性闭塞颈内动脉血栓部位给予尿激酶溶栓治疗,术后立即头颅CT判断有无颅内出血。随访6个月,对所有患者进行美国国立卫生研究院脑卒中量表(NIHSS)、日常生活能力评分(BI)及格拉斯哥昏迷评分(GCS)。结果8例患者闭塞处均位于颈内动脉起始部,6例患者有意识障碍,7例溶栓后血管再通,1例未通,1例溶栓中发生基底节区出血,1例溶栓后第7天猝死。结论急性颈内动脉闭塞患者选择性动脉溶栓是一项有意义的治疗手段,意识障碍并非绝对禁忌证。
Objective To observe the efficacy and safety of local intrarterial thrombolysis for treatment of acute internal carotid artery occlusion disease. Methods After cerebrovacular angiography （DSA）,eight patients were treated by intra-arterial thrombolysis with urokinase within 6 hours after onset. Intracerebral hemorrhage was investigated immediately by CT scanning. No hemorrhage ones were further treated with anticoagulant and antiplatelet drug 12 hours after thrombolysis. All patients were followed-up for 6 months. NIHSS scale,GCS and Barthel index （BI） were used to evaluate the recovery of neurological functions. Results The angiography showed the occlusion of cervical segment of internal carotid artery in all patients. Six patients had consciousness disorder and recovered 1 to 3 days after thrombolysis. The revascularization was successful in 7 patients and their neurological functions were improved. One patient did not get any recanalization. One had complication of intracerebral hemorrhage during thrombolytic treatment and another suddenly died 7 days after thrombolysis. Conclusions Local intra-arterial thrombolysis is a significant treatment method. Acute internal carotid artery occlusion is highly morbid and recanalization is associated with good clinical outcome. Disturbance of consciousness is not a contraindication of intra-arterial thrombolytic treatment.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2008年第1期39-42,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
全军医学科学技术研究"十一五"计划课题面上项目(06MA030)
关键词
颈动脉血栓形成
尿纤溶酶原激活物
脑血管造影
脑梗塞
carotid artery thrombosis
urinary plasminogen activator
cerebral angiography
braininfarction
