摘要
目的探讨动静脉联合溶栓治疗急性缺血性卒中的临床疗效及安全性.方法将65例发病在6 h内的急性缺血性卒中患者随机分为两组:超选择性动脉溶栓+静脉溶栓组(联合组)共35例;超选择性动脉溶栓组(动脉组),30例.动脉组用微导管超选择病变动脉,尿激酶用量50万～150万U.联合组先静脉滴注尿激酶0.5万～1.0万U/kg,再动脉给尿激酶,总量不超过150万U.术前及术后6 h、24 h、7 d、30 d、90 d采用欧洲卒中量表(ESS)评价神经功能缺损情况.结果治疗24 h、30 d后ESS评分联合组为83±24、88±26;动脉组为77±29、81±24.治疗后总再通率:联合组为42.8%,动脉组为33.3%,两组比较差异有显著性(P＜0.05).结论起病6 h内,动静脉联合溶栓与动脉溶栓治疗相比,总再通率增加.
Objective To evaluate the efficacy and safety of combined intravenous and intra-arterial thrombolysis for acute ischemic stroke. Methods 65 patients with acute ischemic stroke of within 6 hours after onset were randomly assigned into two groups. 35 eases were treated with combined superselective intravennus and intra-arterial thromholysis, while 30 with intra-arterial thrombolysis （IAT） alone. In IAT alone group, 500 000 - 1 500 000U urokinase were administered. While in combined treatment group, 5 000 - 10 000U/kg urokinase were given intravenously, followed by IAT. The total amount of Urokinase was no more than 1500 O00U for each patient. The European Stroke Scale （ESS） was used to evaluate the recovery of neurological function for all patients. Results ESS scores were 83 ± 24, 88 ± 26 at 24 hours and 30 days after treatment respectively in combined treatment group, and 77 ± 29, 81 ± 24 in IAT alone group at the same timing. There was significant difference between the two groups （ P 〈 0. 05 ） . The total recanalizatinn rate of combined treatment group （42.8%） was significantly higher than that of IAT alone group （33.3%） . Conclusion Treatment of combined superselective intravenous and intra-arterial thrombolysis for acute ischemic stroke is more effectively than that of local intra-arterial thrombolysis alone, and is safely.
出处
《中国脑血管病杂志》
CAS
2005年第9期397-400,共4页
Chinese Journal of Cerebrovascular Diseases
关键词
卒中
尿激酶
动静脉联合溶栓
Stroke
Urokinase
Combined intravenous and intra-arterial thrombolysis
