【摘要】 目的 探讨急性脑梗塞局部动脉溶栓治疗的时间窗及药物。方法 47例不同时间窗患者给予动脉内灌注尿激酶及罂粟碱，术后判断溶栓疗效，评价时间窗及药物对疗效的影响。结果 血管再通率89.36%，术后3个月随访恢复良好率72.34%，6～8h和6h以内患者血管再通率及预后无差异。结论 局部动脉溶栓是急性脑梗塞的安全有效治疗方法，最佳适应症是大脑中动脉梗塞患者，时间窗应以螺旋CT灌注检查的半暗带作为真正的时间窗依据，原则上可掌握在6～8h以内，术中联合应用尿激酶及罂粟碱可以提高疗效。

    关键词 脑梗塞 时间窗 局部动脉内溶栓

    The study on the drug and time window in early local intra-arterial thrombolysis of acute cerebral infarction

    Wang Peng，Suo Yaohua，Zhang Tieyan，et al.

    Department of Neurosurgery，Changchun Central Hospital，Changchun130051.

    【Abstract】 Objective To investigate the influence of the time window and the drugs to the vessel recanalization in local intra-arterial thrombolysis of acute cerebral infarction.Methods 47cases suffered from acute cerebral infarcˉtion were treated by local intra-arterialthrombolysis with urokinase(UK)and narceine in the different time window.We analysed the effect and evaluated the influence of the time window and drugs to the vessel recanalization and prognosis.Results We got ratio of vessel recanalization is89.36%the ratio of good outcome is72.34%after three months of thrombolysis.There is no diffferent in the vessel recanalization and prognosis between six to eight hour and less than six hour.Conclusion The treatment of local intra-arterial thrombolysis to acute cerebral infarction was safe and effective.The best indication is the infarction atMCA.We should think the the penumbra by CT perfusion as the stander of the time window.In principle we can control the time windowwithin six or eght hour We can also achieve favorable effect by comˉbining the UK and narceine.Key words cerebral infarction time window local intra-arterial thrombolysis ......