中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2014年
2期
156-159
,共4页
符俊骐%夏鹰%史克珊%林佳
符俊騏%夏鷹%史剋珊%林佳
부준기%하응%사극산%림가
急性脑梗死%动脉溶栓%支架取栓%尿激酶
急性腦梗死%動脈溶栓%支架取栓%尿激酶
급성뇌경사%동맥용전%지가취전%뇨격매
Acute cerebral infarction%Arterial thrombolysis%Stent-thrombectomy%Urokinase
目的 探讨支架取栓加尿激酶动脉溶栓与单纯尿激酶动脉溶栓治疗急性脑梗死的临床疗效差异. 方法 选取海口市人民医院神经外科2011年间进行单纯尿激酶动脉溶栓治疗的28例急性脑梗死患者(尿激酶组)和2012年间进行Solitaire AB支架取栓加尿激酶动脉溶栓治疗的29例急性脑梗死患者(支架组)为研究对象,比较2组患者术后神经功能障碍评分、血管再通率、颅内出血率等. 结果 支架组20例大脑中动脉闭塞再通,3例颈内动脉闭塞再通,4例椎基底动脉闭塞再通,再通率为93.1％;术后均无颅内出血发生,2例颈内动脉闭塞患者死亡.尿激酶组15例大脑中动脉闭塞再通,3例颈内动脉闭塞再通,2例椎基底动脉闭塞未通,再通率为64.2％;术后颅内出血5例,死亡8例(颈内动脉闭塞患者6例,椎基底动脉闭塞患者2例).支架组患者术后14d较术前美国国立卫生研究院卒中量表(NIHSS)评分差值与尿激酶组比较(13.37±4.26vs 11.40±4.57)差异有统计学意义(P＜0.05).随访3个月,支架组预后良好(mRS评分＜2)20例,尿激酶组17例. 结论 支架取栓加尿激酶动脉溶栓治疗急性脑梗死的临床疗效优于单纯尿激酶动脉溶栓治疗.
目的 探討支架取栓加尿激酶動脈溶栓與單純尿激酶動脈溶栓治療急性腦梗死的臨床療效差異. 方法 選取海口市人民醫院神經外科2011年間進行單純尿激酶動脈溶栓治療的28例急性腦梗死患者(尿激酶組)和2012年間進行Solitaire AB支架取栓加尿激酶動脈溶栓治療的29例急性腦梗死患者(支架組)為研究對象,比較2組患者術後神經功能障礙評分、血管再通率、顱內齣血率等. 結果 支架組20例大腦中動脈閉塞再通,3例頸內動脈閉塞再通,4例椎基底動脈閉塞再通,再通率為93.1％;術後均無顱內齣血髮生,2例頸內動脈閉塞患者死亡.尿激酶組15例大腦中動脈閉塞再通,3例頸內動脈閉塞再通,2例椎基底動脈閉塞未通,再通率為64.2％;術後顱內齣血5例,死亡8例(頸內動脈閉塞患者6例,椎基底動脈閉塞患者2例).支架組患者術後14d較術前美國國立衛生研究院卒中量錶(NIHSS)評分差值與尿激酶組比較(13.37±4.26vs 11.40±4.57)差異有統計學意義(P＜0.05).隨訪3箇月,支架組預後良好(mRS評分＜2)20例,尿激酶組17例. 結論 支架取栓加尿激酶動脈溶栓治療急性腦梗死的臨床療效優于單純尿激酶動脈溶栓治療.
목적 탐토지가취전가뇨격매동맥용전여단순뇨격매동맥용전치료급성뇌경사적림상료효차이. 방법 선취해구시인민의원신경외과2011년간진행단순뇨격매동맥용전치료적28례급성뇌경사환자(뇨격매조)화2012년간진행Solitaire AB지가취전가뇨격매동맥용전치료적29례급성뇌경사환자(지가조)위연구대상,비교2조환자술후신경공능장애평분、혈관재통솔、로내출혈솔등. 결과 지가조20례대뇌중동맥폐새재통,3례경내동맥폐새재통,4례추기저동맥폐새재통,재통솔위93.1％;술후균무로내출혈발생,2례경내동맥폐새환자사망.뇨격매조15례대뇌중동맥폐새재통,3례경내동맥폐새재통,2례추기저동맥폐새미통,재통솔위64.2％;술후로내출혈5례,사망8례(경내동맥폐새환자6례,추기저동맥폐새환자2례).지가조환자술후14d교술전미국국립위생연구원졸중량표(NIHSS)평분차치여뇨격매조비교(13.37±4.26vs 11.40±4.57)차이유통계학의의(P＜0.05).수방3개월,지가조예후량호(mRS평분＜2)20례,뇨격매조17례. 결론 지가취전가뇨격매동맥용전치료급성뇌경사적림상료효우우단순뇨격매동맥용전치료.
Objective To compare the therapeutic differences between stent-thrombectomy combined with urokinase thrombolysis and simple arterial urokinase thrombolysis in treating patients with acute cerebral infarction.Methods Arterial urokinase thrombolysis was carried out in 28 selected patients with acute cerebral infarction,admitted to our hospital in 2011 (urokinase group),while Solitaire AB stent-thrombectomy combined with arterial urokinase thrombolysis was carried out in 29 patients with acute cerebral infarction,admitted to our hospital in 2012 (combination group).Postoperative indices,including National Institutes of Health Stroke Scale (NIHSS),recanalization rate and intracranial hemorrhage incidence,were analyzed between the two groups.Results Recanaliztion rate of combination group was detailed as:middle cerebral artery in 20 patients,internal carotid artery in 3 patients,and vertebral-basilar artery in 4 patients,with a total recanalization rate of 93.1％.No postoperative hemorrhage was confirmed; two patients diagnosed as having internal carotid artery occlusion died.Recanaliztion rate of urokinase group was detailed as:middle cerebral artery in 15 patients,internal carotid artery in 3 patients,and vertebral-basilar artery in 0 patients,with a total recanalization rate of 64.2％; postopertive intracranial hemorrhage was noted in 5 patients and death in 8.For combination group,postoperative fourteen-day NIHSS scores decreased by 11.40±4.57 as compared with preoperative NIHSS scores; for urokinase group,postoperative fourteen-day NIHSS scores decreased by 11.40±4.57 as compared with preoperative NIHSS scores; significant differece was noted between the two groups (P＜0.05).Postoperative satisfactory rehabilitation (modified Rankin scale scores＜2) in combination group and urokinase group appeared in 20 and 17 patients,respectively,after 3 months of follow up.Conclusion The efficacy of stent-thrombectomy combined with arterial urokinase thrombolysis is superior to that of simple arterial urokinase thrombolysis in patients with acute cerebral infarction.
