【摘要】 目的探讨急性基底动脉闭塞早期溶栓的临床疗效。方法选择急性基底动脉闭塞患者39例,所有患者均接受动脉内早期溶栓治疗,溶栓药物选择尿激酶,药物总量30～100万单位。观察患者溶栓治疗血管再通情况及预后情况。分析溶栓时间、术前美国国立卫生研究院脑卒中量表(NIHSS)评分与患者预后的关系。结果①血管完全再通14例,部分再通21例,未再通4例。患者预后良好21例,预后不良18例,共6例患者死亡。②溶栓时间≤180分者,术后30 d MRS评分0～2分者11例,其比例为57.89%,显著高于溶栓时间181～500分者(P<0.05)。③治疗前NIHSS评分≤20分者,术后30 d MRS评分0～2分者13例,其比例为68.42%,显著高于治疗前NIHSS评分>20分者(P<0.05)。结论急性基底动脉闭塞早期溶栓治疗具有良好的效果,手术时间及术前患者情况与预后相关。更多还原

【Abstract】 Objective To explore the clinical effect of early application of thrombolytics in treatment of acute basilar artery occlusion.Methods A total of 39 patients with acute basilar artery occlusion receiving intra-arterial thrombolytic therapy were chosen for this study,the applied thrombolytic agent was urokinase,and the total dosage was 30-100 million U.The situation of recanalization and prognosis of patients were observed after treatment.The thrombolytic duration,NIHSS scores and prognosis of patients were analyzed.Results 1.There were 14 cases got vascular completely recanalization,21 cases got partial recanalization,and 4 cases were failed in recanalization.Good prognosis had been obtained in 21 cases,and poor prognosis in 18 patients including 6 patients died.2.In patients with thrombolytic time ≤ 180 points,mRS scores 0-2 at 30d after treatment in 11 cases accounted for 57.89%,it was significantly higher than those with thrombolytic time at 181 to 500 points(P<0.05).3.Among patients with pre-treatment NIHSS scores ≤20 points,13 cases with mRS scores 0-2 at 30 d after treatment,accounted for 68.42%,it was significantly higher than those with pre-treatment NIHSS scores>20 points(P<0.05).Conclusion Early thrombolytic therapy in treatment of patients with acute basilar artery occlusion has good efficacy,the operating time and pre-treatment condition of patients are closely related to the prognosis of patients.更多还原