【摘要】 目的探讨动静脉联合溶栓治疗急性脑梗死的临床疗效及安全性。方法将36例发病在3h内的超早期脑梗死患者急诊静脉滴注尿激酶1万U/kg,再超选择病变动脉区域灌注尿激酶0.5万U/kg;与同期29例单纯行超选择病变动脉灌注尿激酶(1万U/kg)的超早期脑梗死患者的疗效对比。术前及术后24h、3d、30d采用欧洲卒中量表(ESS)评价神经缺损功能和Barthel指数(BI)评价日常生活能力,观察疗效和不良反应。结果溶栓24h、3d后ESS评分联合组(组Ⅰ)为82±21,87±23;动脉组(组Ⅱ)为77±25,81±24;溶栓后3d、30dBI指数评分联合组为70.8±27.9,81.5±24;动脉组为61.5±21.3,73.0±28.6,治疗后有效率:组Ⅰ为85.7%,组Ⅱ为75.6%,两组比较差异有显著性(P<0.05)。两组分别有3例和2例患者溶栓后CT显示颅内出血征象,无明显差异。结论动静脉联合溶栓治疗急性脑梗死的疗效优于单纯动脉溶栓,安全性相似。更多还原

【Abstract】 Objective To compare the efficacy and safety of combined intra-artial and intravenous thrombolysis with only intra-arterial thrombolysis for ultra-acute cerebral infarction.Methods 36 patients with ultra-acute cerebral infarction within 6 hours after onset were intrave-nously administered 10 000U/kg urokinase following 5000U/kg urokinase given intra-arterially(group I),While in the same period,the other 29 patients,were given 10 000/kg urokinase intra-arterially alone(group II).The European Stroke Scale(ESS) and Bethel index(BI) were used to evaluate the recovery of neurological deficit function and efficacy and adverse event were observed for all patients in different periods.Results ESS scores were 82±21,87±23 at 24 hours and 3 days after treatment respectively in group I,and 77±25,81±24 in group II,the BI scores were 70.8±27.9,81.5±24 at 3days and 30 days after thrombolysis respectively group I,and 61.5±21.3,73.0±28.6 in group II,There was significant difference between the two groups(P<0.005).The total efficacy rate of group I 85.7% was significantly higher than that of group II 75.6%,there were 3 patients in group I and 2 patients in group II with CT hemorrhage after thrombolysis.Conclusion Combined intravenous and intra-arterial thrombolysis for acute cerebral infarction is more effective than that of intra-arterial thrombolysis alone.The safety is similar between them.更多还原