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目的研究急性脑梗死患者的动脉内介入治疗(选择性动脉内溶栓)的方法及疗效。方法选择2000年1月至2006年12月保定市第二医院神经内科106例急性脑梗死患者,分为选择性动脉内溶栓组(SIAF组)和静脉溶栓组(IVF 组);SIAF 组采用改良 Seldinger 技术,选择性进入闭死动脉,40 min 内泵入尿激酶500 kU和生理盐水60 mL,随时做造影了解动脉是否通畅,不通者再泵入尿激酶30 kU,只要闭死动脉再通,即停止泵入尿激酶。IVF 组40 min 内静脉滴入尿激酶1000 kU 和生理盐水150 mL,不通者再滴入尿激酶30 kU,余同上。结果溶栓后再通者 SIAF 组48例,IVF 组30例,两组比较差异有显著性意义(P<0.01);并发出血者 SIAF 组5例,IVF 组13例,两组比较差异有显著性意义(P<0.01);病情好转者 SIAF 组49例,IVF 组33例;死亡 SIAF 组3例,IVF 组9例,两组比较差异有显著性意义(P<0.01)。结论急性脑梗死患者动脉内介入治疗,既可超早期诊断又可超早期治疗,效果明显。
Objective To study the method and effect of intra-arterial interventional therapy (selective arterial thrombolysis) in patients with acute cerebral infarction. Methods One hundred and sixty patients with acute cerebral infarction in the Second Hospital of Baoding from January 2000 to December 2006 were divided into two groups: selective arterial thrombolysis group (SIAF group) and intravenous thrombolysis group (IVF group); SIAF group The modified Seldinger technique was used to selectively enter the occluded artery. After 40 min, 500 kU of urokinase and 60 mL of saline were pumped into the vessel to make angiography at any time to understand whether the artery was smooth and then not pump 30 kU of urokinase. That is, stop pumping urokinase. In IVF group, urokinase 1000 kU and normal saline 150 mL were intravenously dripped within 40 min. Results There were 48 cases in the SIAF group and 30 cases in the IVF group after thrombolysis. There were significant differences between the two groups (P <0.01). There were 5 cases with SIAF and 13 cases with IVF, (P <0.01). In 49 cases of SIAF and 33 cases of IVF, 3 cases of SIAF died and 9 cases of IVF. There was significant difference between the two groups (P <0.01). Conclusion Intra-arterial interventional therapy in patients with acute cerebral infarction can be both ultra-early diagnosis and ultra-early treatment, the effect is obvious.