【摘要】 目的　评价尿激酶动脉内溶栓治疗急性脑梗死的安全性和疗效。方法　 2 17例急性脑梗死患者接受动脉内尿激酶溶栓治疗 ,患者发病时间 3～ 3 6h ,6h以内 2 3例 ( 10 .6% )。结果　脑血管造影示颈内动脉系统闭塞 119例( 5 4.83 % ) ,椎基动脉系统闭塞 43例 ( 19.82 % ) ;无血管闭塞 5 5例 ( 2 5 .3 5 % )。溶栓后成功再通 10 3例 ( 63 .5 8% ) ,不成功再通 5 9例 ( 3 6.42 % )。 3个月后恢复良好 5 6例 ( 2 5 .80 % ) ,轻度伤残 5 1例 ( 2 3 .5 0 % ) ,重度伤残 5 9例 ( 2 7.19% ) ,植物状态 2 2例 ( 10 .14 % ) ,死亡 2 9例 ( 13 .3 6% )。并发颅内出血 8例 ( 3 .69% )、再灌注损伤 73例 ( 3 3 .64 % )、再栓塞 6例( 2 .76% )。结论　经动脉尿激酶溶栓治疗急性缺血性脑梗死安全有效 ;急性脑梗死溶栓治疗时间窗可适当延长更多还原

【Abstract】 Objective To evaluate the safety and efficacy of local intra-arterial thrombolysis (LIT) using urokinase in patients with acute stroke. Methods Radiological findings and functional outcome 3 months after LIT with urokinase of 217 patients were analyzed and scored with Glasgow outcome scale. Results Angiography showed occlusion of the cerebral artery in 217 patients, of the internal carotid artery segment in 119 (54.83%), and of the vertebrobasilar artery segment in 43 (19.82%). Negative result was found in 55 (25.35%) patients. After intra-arterial treatment with urokinase, successful recanalization was observed in 103 (63.58%) of 162 patients with arterial occlusions. During the 90 days following-up, 56 (25.80%) of the 217 patients had a good outcome, 51 (23.50%) had disabilities, 59 (27.19%) had deformities and 22 (10.14%) had unconscious, but 29 (13.36%) patients died. Hemorrhage occurred in 8 (3.69%) of the trial, and only one survived by physics treatment. Reperfusion injury occurred in 73 (33.64%) patients, arterial reocclusion occurred in 6 ((2.76%)) patients. Conclusion LIT with urokinase is safe and effective therapy in the treatment of acute ischemic stroke. The time window of LIT should be considered some longer than 6 hours.更多还原