【摘要】：目的探討動(dòng)脈溶栓聯(lián)合介入方法治療老年急性腦血管閉塞的臨床效果及安全性。方法 97例老年急性腦血管閉塞患者均采用微導(dǎo)絲、微導(dǎo)管機(jī)械碎栓和(或)Solitaire支架聯(lián)合動(dòng)脈注射重組人組織型纖溶酶原激活物(rt-PA)進(jìn)行治療,分析其治療效果及手術(shù)并發(fā)癥。結(jié)果46例大腦中動(dòng)脈主干閉塞的患者有35例達(dá)到完全再通、11例達(dá)到部分再通,再通率為100%;22例頸內(nèi)動(dòng)脈末端分叉處閉塞的患者有9例達(dá)到完全再通、6例達(dá)到部分再通,再通率為68.18%;11例大腦前動(dòng)脈閉塞的患者有11例達(dá)到完全再通,再通率為100%;18例椎基底動(dòng)脈主干閉塞的患者有4例達(dá)到完全再通、7例達(dá)到部分再通,再通率為61.11%;97例急性腦血管閉塞患者的再通率為85.57%。大腦中動(dòng)脈主干閉塞及大腦前動(dòng)脈閉塞患者的再通率顯著高于頸內(nèi)動(dòng)脈末端分叉處閉塞和椎基底動(dòng)脈主干閉塞的患者(P0.05)。97例急性腦血管閉塞的患者在術(shù)后1 w、2 w及3個(gè)月的美國國立衛(wèi)生研究院卒中量表(NIHSS)平均評分較治療前顯著降低(P0.05),日常生活能力評分量表(ADL)平均評分較治療前顯著的提高(P0.05)。結(jié)論動(dòng)脈溶栓聯(lián)合介入方法治療老年急性腦血管閉塞安全有效,尤其對大腦中動(dòng)脈主干閉塞及大腦前動(dòng)脈閉塞患者具有較好的再通效果。
[Abstract]:Objective to investigate the clinical effect and safety of thrombolytic therapy combined with interventional therapy in elderly patients with acute cerebral vascular occlusion. Methods 97 elderly patients with acute cerebrovascular occlusion were treated with microconductive wire, microcatheter mechanical thrombus breakage and / or Solitaire stents combined with arterial injection of recombinant human tissue plasminogen activator (rt-PA). The therapeutic effect and operative complications were analyzed. Results among 46 patients with middle cerebral artery occlusion, 35 patients had complete recanalization, 11 patients had partial recanalization, and the recanalization rate was 100. Of the 22 patients with occlusion at the end of the internal carotid artery, 9 had complete recanalization and 6 had partial recanalization. The recanalization rate of 11 patients with anterior cerebral artery occlusion was 68.18. 11 patients achieved complete recanalization, and the recanalization rate was 100. Of the 18 patients with vertebrobasilar artery occlusion, 4 had complete recanalization, and 7 had partial recanalization. The recanalization rate was 85.57 in 97 patients with acute cerebrovascular occlusion. The recanalization rate of middle cerebral artery occlusion and anterior cerebral artery occlusion was significantly higher than that of internal carotid artery end bifurcation occlusion and vertebrobasilar artery occlusion (P0.05). After 2 weeks and 3 months, the average (NIHSS) score of the stroke scale of the National Institutes of Health was significantly lower than that before treatment (P0.05), and the average (ADL) score of the ADL scale was significantly higher than that before treatment (P0.05). Conclusion the combination of thrombolytic therapy and interventional therapy is safe and effective in the treatment of acute cerebral vascular occlusion in elderly patients, especially in patients with middle cerebral artery occlusion and anterior cerebral artery occlusion.
【作者單位】： 邢臺市人民醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R743.3

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