[1]齐 立,李慎茂,俸军林,等. 动脉溶栓与机械碎栓联合动脉溶栓的对比分析[J].介入放射学杂志,2012,(03):180-184.
 ,,et al. Comparison of the therapeutic efficacy between simple arterial thrombolysis and mechanical thrombectomy combined with arterial thrombolysis for acute cerebral infarction at its ultraearly stage[J].journal interventional radiology,2012,(03):180-184.
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 动脉溶栓与机械碎栓联合动脉溶栓的对比分析 ()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2012年03期
页码:
180-184
栏目:
神经介入
出版日期:
2012-03-28

文章信息/Info

Title:
 Comparison of the therapeutic efficacy between simple arterial thrombolysis and mechanical thrombectomy combined with arterial thrombolysis for acute cerebral infarction at its ultraearly stage
作者:
 齐 立李慎茂俸军林唐永刚焦力群
Author(s):
 QI Li LI Shenmao FENG Junlin TANG Yonggang JIAO Liqun.
 Department of Neurology, Affiliated Hospital of Guilin Medical College, Guilin 541001, China
关键词:
 【关键词】   急性脑梗死 动脉溶栓 机械碎栓 尿激酶
文献标志码:
A
摘要:
 摘要】 目的 比较两种不同动脉溶栓方法治疗超早期脑梗死患者的疗效,探讨哪种方法更有益于开通血管。方法 收集2009年10月- 2011年5月55例脑梗死急性期并行超早期介入治疗患者,其中25例(联合治疗组)采用机械碎栓联合尿激酶进行动脉内溶栓治疗,30例(尿激酶组)采用尿激酶进行单纯动脉内溶栓治疗。术后观察患者闭塞血管再通和神经功能障碍恢复情况,并比较分析两种动脉溶栓方法的疗效。结果 联合治疗组患者血管再通23例,成功再通率为92%(23/25),尿激酶组患者则为18例,再通成功率仅为60%(18/30)。术后平均NIHSS(脑卒中量表)及ADL(日常活动量表)评分联合治疗组(1 h 分别为8.6 ± 2.5和20.0 ± 4.6;24 h分别为9.0 ± 1.8和17.0 ± 2.5)改善程度明显优于尿激酶组(1 h分别为7.5 ± 2.0和28.0 ± 3.5;24 h分别为8.1 ± 2.0和24.0 ± 2.1),两组间差异有统计学意义(P < 0.05)。尿激酶用量及溶栓时间联合治疗组分别为(36.8 ± 8.4)万u和(35.3 ± 11.6)min,尿激酶组分别为(50.4 ± 15.3)万u和(55.7 ± 13.3)min, 前者低于后者,两组间差异有统计学意义(P < 0.05)。结论 超早期应用动脉内机械碎栓联合动脉溶栓治疗急性脑梗死的疗效优于单纯动脉溶栓。

参考文献/References:

 [1] 卫生部疾病控制司. 中华医学会神经病学分会.中国脑血管病防治指南(节选)[J]. 中国现代神经疾病杂志, 2007, 7: 217  256.
[2] 高元桂, 蔡幼铨, 蔡祖龙. 磁共振诊断影像学[M]. 北京: 人民军医出版社, 1993: 196  200.
[3] Astrup RH. Thresholds in cerebral ischemiathe ischemic penumbra[J]. Stroke, 1981, 12: 723  725.
[4] Smith WS. Pathophysiology of focal cerebral ischemia: a therapeutic perspective[J]. J Vasc Interv Radiol, 2004, 15(1 Pt 2): S3  12.
[5] Jordn J, Ikuta I, GarcíaGarcía J, et al. Stroke pathophysiology: management challenges and new treatment advances[J]. J Physiol Biochem, 2007, 63: 261  277.
[6] 张永巍, 刘建民, 洪 波, 等. 急性脑梗死患者超选择性局部动脉溶栓治疗[J]. 介入放射学杂志, 2004, 12(S1): 143  145.
[7] 朱凤水, 李慎茂, 缪中荣, 等. 急性缺血性脑卒中动脉内溶栓治疗临床分析[J]. 中国神经精神疾病杂志, 2005, 31: 289  290.
[8] Higashida RT, Dion J. Interventional treatment and management of ischemic stroke[J]. J Vasc Interv Radiol, 2004, 15: 1  3.
[9] Bourekas EC, Silvka AP, Shah R, et al. Intraartral thrombolytic therapy wthin 3 hours of onset stroke[J]. Neurosurgery, 2004, 54: 39  44.
[10] 朱青峰, 王国芳, 王 千,等. 机械碎栓联合颅内动脉注射尿激酶、罂粟碱治疗急性脑血管闭塞的疗效观察[J]. 中国当代医药, 2009, 16: 9  10.
[11] 李 杨, 邢成名, 杜冠华. 神经精神疾病合理用药[M]. 北京: 人民卫生出版社, 2009: 122.
[12] Higashida RT, Furlan AJ, Roberts H, et al. Trial design and reporting standards for intraarterial cerebral thrombolysis for acute ischemic stroke[J]. Stroke, 2003, 34: e109  e137.
[13] Sorimachi T, Fujii Y, Tsuchiya N, et al. Recanalization by mechanical embolus disruption during intraarterial thrombolysis in the carotid territory[J]. AJNR, 2004, 25: 1391  1402.
[14] 鲁海涛, 李明华, 赵俊功, 等. 机械取栓在急性血栓性脑卒中的应用[J]. 介入放射学杂志, 2008, 17: 601  604.
[15] Brekenfeld C, Schroth G, Mordasini P, et al. Impact of retrievable stents on acute ischemic stroke treatment[J]. Neuroradiology, 2011, 32: 1269  1273.
[16] 缪中荣. 急性缺血性卒中经动脉溶栓技术探讨[J]. 中国脑血管病杂志, 2005, 2: 97  101.
[17] Ringer AJ, Qureshi AI, Fessler RD, et al. Angioplasty of intracranial occlusion resistant to thrombolysis in acute ischemic stroke[J]. Neurosurgery, 2001, 48: 1282  1288.
[18] Nakano S, Iseda T, Yoneyama T, et al. Direct precut aneous transluminal angioplasty for acute middle cerebral artery trunk occlusion: an alternative option to intraarterial thrombolysis[J]. Stroke, 2002, 33: 2872  2876.
[19] 史   跃, 高从敬, 孟宪俊, 等. 颅内动脉溶栓联合机械碎栓治疗急性脑梗死[J]. 介入放射学杂志, 2008, 17: 309  312.
[20] Ng PP, Higashida RT, Cullen SP, et al. Intraarterial thrombosis trials in acute ischemic stroke[J]. J Vase Radiol, 2004, 15: 77  85.
[21] Arnold M, Nedeltchev K, Schroth G, et al. Clinical and radiological predictors of recanalisation and outcome of 40 patients with acute basilar artery occlusion treated with intraarterial thrombolysis[J]. J Neurol Neurosur Psychiatry, 2004, 75: 857  862.
[22] 张  冰, 郑少俊, 方   淳, 等. rtPA动脉溶栓治疗急性脑梗死的疗效观察[J]. 介入放射学杂志, 2007, 16: 580  583.
[23] Hussein HM, Georgiadis AL, Vazquez G, et al. Occurrence and predictors of futile recanalization following endovascular treatment among patients with acute ischemic stroke: a multicenter study[J]. AJNR, 2010, 31: 454  458.
[24] 齐   立, 李慎茂, 焦力群, 等. 颈动脉支架术高灌注损伤因素分析[J]. 中华神经外科杂志, 2010, 26: 32  34.
[25] Gates J, Hartnell GG. When urokinase was gone: commentary on another year of thrombolysis without urokinase[J]. J Vasc Interv Radi, 2004, 15(1 Pt 1): 1  5.

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 (收稿日期:20110928)
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