CAJ | 학술논문

目的观察动脉溶栓介入治疗6 h内急性颈内动脉系统脑梗死患者的有效性和安全性.方法选择27例病史6 h内的急性颈内动脉系统脑梗死患者进行选择性动脉溶栓介入治疗,同期选择年龄、病情相匹配的、病史6 h内的无溶栓的对照患者27例常规给予普通治疗,治疗前、治疗后各时点采用美国国立卫生研究院卒中量表(NIHSS)、Barthel指数(BI)进行评分及疗效评定.结果两组各时点的NIHSS、BI评分相比,动脉溶栓组均优于对照组,有统计学意义.动脉溶栓组27例患者中溶栓后血管完全再通17例,部分再通4例,未通6例,血管再闭塞伴颅内出血1例,死亡1例,术后90 d生活状态优者(BI≥90)14例,良者(50≤BI＜90)6例,差者(BI＜50)7例,血管再通者生活状态最优.结论动脉内介入溶栓治疗急性颈内动脉系统脑梗死是一种安全有效的方法,严格把握手术时间窗,积极治疗能明显降低致死率及致残率.
목적 관찰동맥용전개입치료6 h내급성경내동맥계통뇌경사환자적유효성화안전성.방법 선택27례병사6 h내적급성경내동맥계통뇌경사환자진행선택성동맥용전개입치료,동기선택년령、병정상필배적、병사6 h내적무용전적대조환자27례상규급여보통치료,치료전、치료후각시점채용미국국립위생연구원졸중량표(NIHSS)、Barthel지수(BI)진행평분급료효평정.결과 량조각시점적NIHSS、BI평분상비,동맥용전조균우우대조조,유통계학의의.동맥용전조27례환자중용전후혈관완전재통17례,부분재통4례,미통6례,혈관재폐새반로내출혈1례,사망1례,술후90 d생활상태우자(BI≥90)14례,량자(50≤BI＜90)6례,차자(BI＜50)7례,혈관재통자생활상태최우.결론 동맥내개입용전치료급성경내동맥계통뇌경사시일충안전유효적방법,엄격파악수술시간창,적겁치료능명현강저치사솔급치잔솔.
Objective To observe the effectiveness and safety of intra-arterial thrombolysis intervention therapy for the patients who had suffered from the acute cerebral infarction in internal carotid artery for 6 hours.Methods A total of 27 cases patients (thrombolysis group),who had suffered from the acute cerebral infarction in internal carotid artery for 6 hours,were conducted the selective thrombolysis intervention therapy.Simultaneously,other 27 cases acute cerebral infarction patlents,who had the same ages,condition and 6-hour case history with the thrombolysis group,were conducted the regular treatment without thrombolysis(control group).The curative effects before and after treatment were appraised by the use of U.S.A National Institutes of Health Stroke Scale(NIHSS) and Barhel Index(BI).Results After comparing the NIHSS and BI values in different times of two groups,the values in thrombolysis group were better than those in control group,which was statistically significant.Among the 27 cases patients in thrombolysis group,17 cases were complete recanalization after thrombolysis therapy,4 cases were partial recanalization,6 cases were still obstructive,1 case was reinfarction with intracerebral hemorrhage combined and 1 case was dead.After 90 days of operation,14 cases had optimal life behavior(BI ≥90) ,6 cases had good life behavior(50 ≤ BI ＜ 90) and 7 cases had bad life behavior(BI ＜ 50).The patients whose blood vessel had re-canalized had the optimal life behavior.Conclusion The intra-arterial thrombolytic therapy is a safe and effective method for the treatment of acute cerebral infarction in internal carotid artery system.If the optimal time course is controlled strictly and active treatment is conducted,the lethality rate and deformity rate will be largely reduced.