CAJ | 학술논문

目的：观察超选择性动脉内接触性溶栓及机械碎栓治疗急性脑梗死临床效果。方法对2006年1月-2014年1月收治的时间窗内急性脑梗死28例给予超选择性动脉内接触性溶栓及机械碎栓，同时给予扩容、抗血小板等治疗，评价治疗后即刻血管再通率、术后1 h、2周、3个月美国国立卫生研究院脑卒中量表（ NIHSS）、日常活动量表（ ADL）评分情况。结果本组动脉内接触性溶栓后即刻血管完全再通率为75%，部分再通率为25%，4例血管再通后残留狭窄>80%，给予支架置入术；除1例死于中枢性呼吸衰竭外，其余27例术后1 h、2周、3个月NIHSS、ADL评分较治疗前改善（ P<0.05）。结论动脉内接触性溶栓结合机械碎栓治疗时间窗内急性脑梗死安全、有效。
목적：관찰초선택성동맥내접촉성용전급궤계쇄전치료급성뇌경사림상효과。방법대2006년1월-2014년1월수치적시간창내급성뇌경사28례급여초선택성동맥내접촉성용전급궤계쇄전，동시급여확용、항혈소판등치료，평개치료후즉각혈관재통솔、술후1 h、2주、3개월미국국립위생연구원뇌졸중량표（ NIHSS）、일상활동량표（ ADL）평분정황。결과본조동맥내접촉성용전후즉각혈관완전재통솔위75%，부분재통솔위25%，4례혈관재통후잔류협착>80%，급여지가치입술；제1례사우중추성호흡쇠갈외，기여27례술후1 h、2주、3개월NIHSS、ADL평분교치료전개선（ P<0.05）。결론동맥내접촉성용전결합궤계쇄전치료시간창내급성뇌경사안전、유효。
Objective To observe the clinical effect of super selective intra-arterial thrombolysis combined with mechanical thrombectomy in treatment of acute cerebral infarction. Methods A total of 28 patients with acute cerebral infarction during January 2006 and January 2014 underwent super selective intra-arterial thrombolysis combined with me-chanical thrombectomy treatment,and the conventional treatments such as expansion and antiplatelet treatments were giv-en at the same time. The immediately postsurgical revascularization rate,and the scores of the National Institutes of Health stroke scale( NIHSS)and activity of daily living( ADL)on 1 h,2 weeks and 3 months after the treatment were evaluated. Results After the treatment,the complete recanalization rate was 75%,and partial recanalization was 25%, the residual stenosis was more than 80% in 4 patients after recanalization,and stenting insertion was performed at the same time;the scores of NIHSS and ADL on 1 h,2 weeks and 3 months after the operation in the 27 patients were im-proved(P<0. 05),except 1 patient who died of central respiratory failure. Conclusion The intra-arterial thrombolysis combined with mechanical thrombectomy in treatment of acute cerebral infarction is safe and effective.