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目的观察动脉内超选择性溶栓或/和血管内支架成形术治疗急性或进展性缺血性脑梗死的疗效及并发症。方法采用随机对照方法,将38例因粥样硬化所致急性或进展性脑血管栓塞病例,分为治疗组21例(选择性脑动脉内接触溶栓辅以血管内支架成形术)和对照组17例(单纯选择性脑动脉内接触溶栓),进行疗效及并发症等方面的对比研究。结果治疗组治疗急性或进展性缺血性脑梗死,其血管再通率、神经功能缺损评分降低程度、临床预后均优于对照组;治疗后血管再狭窄、再闭塞率低于对照组;症状性出血率高于对照组。结论选择性脑动脉内接触溶栓结合血管内支架成形术治疗急性或进展性缺血性脑梗死,是一积极、有效、相对安全的方法。
Objective To observe the efficacy and complications of intra-arterial superselective thrombolysis and / or endovascular stenting in the treatment of acute or progressive ischemic stroke. Methods A total of 38 patients with acute or progressive cerebrovascular embolism due to atherosclerosis were divided into treatment group (21 cases) (selective intracerebral thrombolysis with endovascular stent graft) and control group 17 cases (selective intracerebral thrombolysis), the efficacy and complications of the comparative study. Results The treatment group was better than the control group in the treatment of acute or progressive ischemic stroke, and the rate of revascularization, neurological deficit score and clinical prognosis were better than those of the control group. The restenosis rate and reocclusion rate were lower in the treatment group than those in the control group. Sexual bleeding rate was higher than the control group. Conclusions Selective intracerebral exposure with intracerebral thrombolysis and endovascular stenting is a positive, effective and relatively safe method for the treatment of acute or progressive ischemic stroke.