【作者】 隋建美； 出良钊； 刘健； 杨华； 宋世宾； 董明昊；

【Author】 SUI Jian-Mei,CHU Liang-Zhao, LIU Jian,YANG Hua,DONG Ming-Hao, SONG Shi-Bin,CHEN Yi-Min.Department of Neurosurgery,Hospital Affiliated to Guiyang Medical College, Guiyang 550004,China

【机构】 贵阳医学院附属医院神经外科；

【摘要】 目的探讨应用r-tpA动静脉联合溶栓治疗急性缺血性卒中的临床疗效及安全性。方法将53例发病在6h内的急性缺血卒中患者随机分为两组:超选择性动脉溶栓+静脉溶栓组(联合组)共30例;超选择性动脉溶栓组(动脉组),23例。动脉组用微导管超选择病变动脉,注入r-tpA50mg。联合组先静脉滴注r-tpA再动脉内给r-tpA,总量不超过50mg。术前及术后6h、24h、7d、30d、采用欧洲卒中量表(ESS)评价神经功能缺损情况。结果治疗24h、30d后ESS评分联合组为82± 23、89±25:动脉组为76±27、82±23。治疗后总再通率:联合组56．9％,动脉组 33.3％,两组比较差异有显著性(P<0．05)。结论起病6h内,动静脉联合溶栓与动脉溶栓治疗相比,总再通率增加。更多还原

【Abstract】 Objictive To evaluate the efficacy and safety of combined intravenous and intra-arterial thrombolysis using r-tpA for acute ischemic stroke.Methods 53patients with acute ischemic stroke of within 6 hours after onset were randomly assigned into two groups. 30 cases were treated with combined superselective intravenous and intra-arterial thrombolysis,while 23 with intra-arterial thromblysis (IAT) alone. In IAT alone group, 50mg r-tpA were administered. While in combined treatment group, r-tpA were given intravenously, followed by IAT. The total amount of r-tpA was no more than 50mg for each patient. The European Stroke Scale (ESS) was used to evaluate the re-covery of neurological function for all patients. Results ESS scores were 82±23,89±25 at 24 hours and 30 days after treatment respectively in combined treatment group, and 76±27, 82±23 in IAT alone group at the same timing.There was significant difference between the two groups (P < 0.05 = .The total recanalization rate of combined treatment group(56. 9%) was significantly higher than that of IAT alone group(33. 3%). Conclusion Treatment of combined superselective intravenous and intra-arterial thrombolysis alone,and is saely.更多还原