急性颈内动脉系统脑梗死动脉溶栓介入治疗的临床研究(1)
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【摘要】 目的 观察动脉溶栓介入治疗6 h内急性颈内动脉系统脑梗死患者的有效性和安全性。方法 选择27例病史6 h内的急性颈内动脉系统脑梗死患者进行选择性动脉溶栓介入治疗,同期选择年龄、病情相匹配的、病史6 h内的无溶栓的对照患者27例常规给予普通治疗,治疗前、治疗后各时点采用美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)进行评分及疗效评定。结果 两组各时点的NIHSS、BI评分相比,动脉溶栓组均优于对照组,有统计学意义。动脉溶栓组27例患者中溶栓后血管完全再通17例,部分再通4例,未通6例,血管再闭塞伴颅内出血1例,死亡1例,术后90 d生活状态优者(BI≥90)14例,良者(50≤BI<90)6例,差者(BI<50)7例,血管再通者生活状态最优。结论 动脉内介入溶栓治疗急性颈内动脉系统脑梗死是一种安全有效的方法,严格把握手术时间窗,积极治疗能明显降低致死率及致残率。
【关键词】脑梗死;动脉溶栓;介入治疗
Clinical research on the intra arterial thrombolysis intervention therapy for the acute cerebral infarction in internal carotid artery system
CHEN Hai,YUAN Li,NI Fuwen,et al.Department of Neurology of Guangdong Maoming City People’s Hospital,Guangdong, Maoming 525000,China
【Abstract】 Objective To observe the effectiveness and safety of intra arterial thrombolysis intervention therapy for the patients who had suffered from the acute cerebral infarction in internal carotid artery for 6 hours.Methods A total of 27 cases patients(thrombolysis group),who had suffered from the acute cerebral infarction in internal carotid artery for 6 hours,were conducted the selective thrombolysis intervention therapy.Simultaneously,other 27 cases acute cerebral infarction patients,who had the same ages,condition and 6 hour case history with the thrombolysis group,were conducted the regular treatment without thrombolysis(control group).The curative effects before and after treatment were appraised by the use of U.S.A National Institutes of Health Stroke Scale(NIHSS)and Barhel Index(BI).Results After comparing the NIHSS and BI values in different times of two groups,the values in thrombolysis group were better than those in control group,which was statistically significant.Among the 27 cases patients in thrombolysis group,17 cases were complete recanalization after thrombolysis therapy,4 cases were partial recanalization,6 cases were still obstructive,1 case was reinfarction with intracerebral hemorrhage combined and 1 case was dead.After 90 days of operation,14 cases had optimal life behavior(BI≥90),6 cases had good life behavior(50≤BI<90)and 7 cases had bad life behavior(BI<50) ......
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