超选择性动脉接触性溶栓联合机械碎栓术治疗急性脑梗死的研究

发表时间：2014-06-19 浏览次数：1121次

引用：

宋军，史万超，苏志国等.超选择性动脉接触性溶栓联合机械碎栓术治疗急性脑梗死的研究[J].上海交通大学学报（医学版）.2013, 33(3):314-317

关键词：

溶性治疗;机械碎栓;脑梗死

作者：

宋军，史万超，苏志国，马晨，刘振林，卢俏丽

作者单位：

天津市第五中心医院神经内科,天津,300450; 天津市第五中心医院神经外科,天津,300450

出版年份：

2013

期刊页数：

314-317

收录者：

知网,万方

摘要：

目的研究超选择性动脉接触性溶栓联合机械碎栓术治疗急性脑梗死的有效性和安全性.方法对30例急性脑梗死患者实施超选择性动脉接触性溶栓联合机械碎栓术治疗.通过数字减影血管造影术(DSA)显示血管再通情况；于溶栓前以及溶栓后7d和1、3个月时,采用NIHSS评分对患者神经功能缺损进行评估；于溶栓前和溶栓后即刻及1、3d时,采用GCS评分对患者意识状况进行评估；于溶栓后1、3个月时,采用Barthel指数(BI)对患者生活活动能力进行评估.溶栓后行头颅CT检查了解患者症状性颅内出血的发生情况.结果 30例患者经超选择性动脉接触性溶栓联合机械碎栓术治疗,26例患者血管再通,血管再通率达86.7％.与溶栓前比较,溶栓后7d和1、3个月的NIHSS评分明显降低,差异有统计学意义(P＜0.05).与溶栓前比较,溶栓后即刻及1、3d的GCS评分明显升高,差异有统计学意义(P＜0.05).溶栓后1、3个月的BI优良率分别为76.7％和80.0％.溶栓后影像学检查显示症状性颅内出血的发生率为6.7％.结论采用超选择性动脉接触性溶栓联合机械碎栓术治疗急性脑梗死,可提高血管再通率,改善患者预后,是一种较安全、有效的治疗方式. Objective To investigate the eflicacv and safet)一。>f superselective arterial thrombolysis combined with mechanical thrombectomv for the treatment of acute cerebral infarction. Methods Thirty patients with acute cerebral infarction were treated with superselective arterial thronoolvsis combined with mechanical thrombectomv. The vascular recanalization was illustrated by digital subtraction angiograph}(1> SA)·The neurological deficits were assessed by l}IHSS before thrombolvsis and 7 d, I month and 3 months after thrombolvsis. The state of consciousness was evaluated by GCS before thrombolysis, immediately after thrombolvsis and 1 d and 3 d after thrombolvsis. The state of life was examined by Barthel Index(BI) 1 month and 3 months after thrombolvsis. The symptomatic intracranial hemorrhage after thrombolysis cvas investigated by brain CT、(an. Resz}lts After treatment, 26 patients had vascular recanalization, and the rate of vascular recanalization was 86.7%.The scores of NIHSS 7 d; 1 month and 3 months after thrombolysis were significantly lower than that before山rombolvsis(P

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