摘要
目的观察局部注射尿激酶动脉溶栓治疗急性脑梗死的疗效及并发症。方法对48例发病于6 h内的急性脑梗死患者行动脉内超选择性尿激酶溶栓治疗。其中颈内动脉主干闭塞5例(10.4%),大脑中动脉主干及分支闭塞36例(75.0%),大脑前动脉闭塞4例(8.3%),椎基底动脉闭塞3例(6.3%)。结果经溶解血栓治疗后完全再通28例(58.3%),部分再通11例(22.9%),未通9例(18.8%);溶解血栓治疗后3个月疗效良好的患者33例,疗效差者15例;39例溶通患者中疗效良好者31例(79.5%),9例未溶通患者中疗效良好者2例(22.2%);溶栓后脑出血11例(22.9%)。结论局部动脉溶栓治疗能明显提高血管再通率,明显改善预后,是治疗急性脑梗死的一种有效的方法。
Objective To observe the efficacy and complication of local intra-arterial thrombolysis（LIT） using urokinase in patients with acute cerebral infarction.Methods 48 patients with acute cerebral infarction within 6h from onset were treated with intra-arterial thrombolysis using urokinase.The locations of occlusion included of 5 internal carotid artery（ICA）,36 of middle cerebral artery（MCA）,4 of anterior cerebral artery（ACA） and 3 of the posterior circulation.Results Complete recanalization after thrombolysis were observed in 28 of the 48 patients（58.3%）,partial recanalization in 11 of the 48 patients（22.9%）,no recanalization in 9 of the 48 patients（18.8%）.The clinical outcome 3 months after thrombolysis was evaluated according to MRS score.33 patients were good outcome（MRS score ≤ 2） and 15 patients were poor outcome（MRS score ≥ 3）.39 of the 48 patients（79.5%） of complete/partial recanalization were good outcome,only 2 of the 9 patients（22.2%） of no recanalization were good outcome.Cerebral hemorrhages occurred in 11 patients（22.9%） after thrombolysis.Conclusion LIT using urokinase can apparently improve the rate of recanalization and clinical outcome.It is an effective and relatively safe therapy in the treatment of acute cerebral infarction.
出处
《中国临床保健杂志》
CAS
2009年第6期595-597,共3页
Chinese Journal of Clinical Healthcare
关键词
脑梗死
血栓溶解疗法
尿纤溶酶原激活物
输注
动脉内
Brain infarction
Thrombolytic therapy
Urinary plasminogen activator
Infusions, intra-arterial
