动脉溶栓联合血管内支架成形术对急性脑梗死治疗作用.docVIP

动脉溶栓联合血管内支架成形术对急性脑梗死治疗作用 　 ; 作者：何锐，张素平，杜德坤，邓婉青，王慕真，何丽婵 【摘要】; 目的 评价动脉溶栓联合血管内支架成型术治疗急性颈内动脉系统脑梗死的疗效与安全性。方法 22例动脉溶栓后遗有血管狭窄的急性脑梗死患者，男性10例，女12例，平均年龄（66.18±11.49）岁，均在发病6 h内接受治疗。分为治疗组10例和对照组12例，分别给予支架治疗和常规药物治疗，于术后第1天和30天比较两组NIHSS评分及病死率。结果 与对照组相比，治疗组患者临床症状明显改善，术后1 d和30 d的NIHSS评分都显著降低（Plt;0.05）。治疗组无1例死亡。结论 动脉溶栓联合血管内支架成型术治疗急性脑梗死较单纯动脉溶栓疗效好，而且较为安全。 【关键词】; 急性脑梗死 ； 动脉溶栓 ；血管内支架成形术 　　Abstract; : Objective To evaluate the safety and efficacy of intraarterial thrombolytic therapy in combination with percutaneous transluminal angioplasty （PTA）on acute cerebral infarction of internal carotid artery system. Methods 22 patients with acute cerebral infarction (10 male and 12 female) were divided into two groups, who were treated with intraarterial thrombolysis therapy within 6 hours after symptom onset and remained angiostegnosis with the mean age of 66.18±11.49yearsold.The patients in the therapeutic group (10 cases) were treated with percutaneous transluminal angioplasty, while the patients in the control group (12 cases) were treated with conventional medicine.The death rate and NIHSS (National Institutes of Health Stroke Scale) scores were evaluated on the 1st day as well as 30th day after PTA.Results Combined therapy improved the symptoms of the patients with acute ischemic stroke and significantly lowered the scores of NIHSS on the 1st day and 30th day after PTA (Plt;0.05).There were no died case in treated group.Conclusion; The combined therapy of acute cerebral infarction with intraarterial thrombolytic and percutaneous transluminal angioplasty is more effective and safer than that treated with intraarterial thrombolytic therapy only. ; 　　Key words：arterial thrombolysis; percutaneous transluminal angioplasty; acute cerebral infarction 　　急性脑梗死治疗关键是使闭塞血管再通，溶栓疗法被认为是其根本性治疗方法之一。动脉溶栓能够提高血管再通率，但部分患者遗留有血管狭窄，溶栓治疗无法使血管完全再通。近年来研究者在不断探索溶栓治疗的同时行血管内成形术或放置血管内支架等，以提高再通率，进一步提高疗效。我科应用动脉溶栓联合血管内支架成形术治疗急性脑梗死，探讨其疗效及安全性。 　　1; 资料与方法 　　1.1; 一般资料 　　2004年10月～2006年4月在我院行动脉溶栓治疗的颈动脉系统病变的急性脑梗死患者共26例。