[1]关玉华　艾克拜尔·加马力　曹莹莹.超选择性动脉溶栓治疗急性脑梗死的临床研究[J].中国临床神经外科杂志,2015,(04):222-224.[doi:10.13798/j.issn.1009-153X.2015.04.010]
　GUAN Yu-hua,JIAMALI AiKkebaier,CHEN Shi-bao,et al.Superselective intra-arterial thrombolytic therapy early after infraction in 217 patients with actue cerebral infraction[J].,2015,(04):222-224.[doi:10.13798/j.issn.1009-153X.2015.04.010]
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超选择性动脉溶栓治疗急性脑梗死的临床研究()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年04期
页码:
222-224
栏目:
论著
出版日期:
2015-04-30

文章信息/Info

Title:
Superselective intra-arterial thrombolytic therapy early after infraction in 217 patients with actue cerebral infraction
文章编号:
1009-153X（2015）04-0222-03
作者:
关玉华　艾克拜尔·加马力　曹莹莹
841000 新疆库尔勒，新疆巴州人民医院神经外科（关玉华、艾克拜尔.加马力、曹莹莹）
Author(s):
GUAN Yu-hua;  JIAMALI AiKkebaier;  CHEN Shi-bao;  CAO Ying-ying.
Department of Neurology, Xinjiang Bazhou People’s Hospital, Korla, Xinjiang 841000, China
关键词:
急性脑梗死; 动脉溶栓; 尿激酶
Keywords:
Acute cerebral infarction;  Thrombolysis;  Urokinase
分类号:
R743.3;R815.2
DOI:
10.13798/j.issn.1009-153X.2015.04.010
文献标志码:
A
摘要:
目的 探讨尿激酶超选择性动脉溶栓治疗急性脑梗死的安全性和有效性。方法 前瞻性收集急性脑梗死病人217例，先行全脑血管造影明确责任血管部位，然后用导引导管或微导管按1万U/min的速度向责任血管泵入尿激酶，每注射10万U即重复血管造影，如果造影显示堵塞血管已经再通则停止溶栓治疗，在治疗2 h、 24 h、7 d、14 d按我国第四届脑血管病学术会议通过的脑卒中患者临床神经功能缺损程度评分标准评定疗效。结果 溶栓后，血管再通率为65.90%（143/217），溶栓2 h、24 h、7 d和14 d的有效率分别为70.05%、70.97%、76.96%和79.26%。结论 对于急性脑梗死患者，超早期溶栓能恢复血流灌注，阻断脑梗死病理过程，避免脑细胞坏死，明显提高治愈率，降低致残率。
Abstract:
Objective To explore the safety of superselective intra-arterial thrombolytic treatment of cerebral infraction and its effect. Methods DSA was performed after the puncture of the femoral arteries with Seldinger technique in order to determine the arteries responsible for cerebral infraction. Urokinase (UK) was infused into the arteries responsible for the cerebral infraction at a speed of 10 000 U/min. The cerebral angiography was repeated after each infusion of 100 000 U UK. The infusion of UK stopped when the angiography showed the recanalization of the occluded arteries. The total dose of UK per patients ranged 200 000 to 1 500 000 U. The recanalizaion rate of the occluded arteries was calculated after the thrombolysis and the curative effects were observed 2 and 24 hours, and 7 and 14 days after the thrombolysis. Results The rate of the complete and part recanalizations of the occluded arteries was 65.9% (143/217) after the thrombolysis. The effective rates were 70.97%, 76.96%, 79.26% respectively 2 and 24 hours, and 7 and 14 days after the thrombolysis. Conclusion The curative effect of early superselective intrarterial thrombolysis therapy on the acute cerebral infarction is good.

参考文献/References:

[1] 中华医学会神经科学会. 各类脑血管疾病病诊断要点[J]. 中华神经科杂志，1996，29（6）：379.
[2] 全国第四届脑血管病学术会议. 脑卒中患者临床神经功 能缺损程度评分标准（1995）[J]. 中华神经科杂志，1996， 29：381-383.
[3] Liu M, Wu B, Wang WZ, et al. Stroke in China: epidemio- logy, prevention, and management strategies [J]. Lancet Neurol, 2007, 6: 456-464.
[4] 沈　霞，董瑞国，剂永海，等. 超选择性动脉溶栓治疗急 性脑梗塞的32例[J]. 中国神经精神疾病杂志，2000，26： 254.
[5] 蒋彦钧，李玉明. 动脉和静脉溶栓治疗大脑中动脉闭塞的 回顾性分析[J]. 中国临床神经外科杂志，2012，17：662- 664.
[6] Madden K. Optimal timing of thrombolytic therapy in acute ischaemic stroke [J]. CNS Drugs, 2002, 16(4)：213-218.
[7] Higashida RT, Furlan AJ. Trial design and reporting stan- dards for intraarterial cerebral thrombolysis for acute ische- mic stroke [J]. Stroke, 2003, 34：109-137.
[8] Endo S, Kuwayma N, Hirashima Y, et al. Results of urgent thrombolysis in patients with major stroke and athero- thrombotic occlusion of the cervical internal carotid artery [J]. Am J Neuroradiol, 1998, 19(6)：1169-1175.
[9] 李慎茂，缪中荣，朱凤水，等.脑栓塞急诊溶栓与颅内支架 成形术的临床应用[J].中华医学杂志，2003，83（1）：9-12.
[10] Lyden P. Thrombolytic therapy for acute stroke: not a mo- ment to lose [J]. N Engl J Med, 2008, 359：1393-1395.
[11] 刘　鸣. 脑血管病循证医学与个体化处理不相对立[J]. 中 华神经科杂志，2006，39：577-579.

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更新日期/Last Update: 2016-04-25