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目的观察动脉溶栓治疗急性颈内动脉闭塞所致缺血性脑梗死的疗效及并发症。方法对10例发病在6h内的患者行动脉溶栓治疗,并对其中2例辅以经皮腔内血管成形术(PTA)或颈动脉内膜剥脱术(CEA)治疗。血管再通程度用TIMI分级评价。临床结果评价在溶栓后30d进行,根据ModifiedRankinScale(MRS)分类。结果溶栓前10例患者均为TIMI0～1,溶栓后8例部分/完全再通,其中7例结果良好(MRS0～3)。发生症状性脑出血2例(10%)。结论症状发作6h内的动脉溶栓可明显改善急性颈内动脉闭塞所致缺血性脑梗死患者的预后,降低死亡率。
Objective To observe the efficacy and complications of arterial thrombolysis in the treatment of ischemic cerebral infarction caused by acute carotid artery occlusion. Methods Thrombolysis was performed in 10 patients within 6 hours and 2 of them were treated with percutaneous transluminal angioplasty (PTA) or carotid endarterectomy (CEA). The extent of revascularization was assessed using TIMI grading. Clinical outcome evaluations were performed 30 days after thrombolysis and classified according to Modified Rankinage (MRS). Results The 10 patients before TIMI were all TIMI0 ~ 1. After thrombolysis, 8 cases were partially / completely recanalized, of which 7 cases were good (MRS 0 ~ 3). Symptomatic intracerebral hemorrhage in 2 cases (10%). Conclusion Intra-arterial thrombolysis within 6 hours after symptom onset can significantly improve the prognosis and reduce the mortality of patients with ischemic cerebral infarction caused by occlusion of internal carotid artery.