动脉内溶栓联合血管成形术治疗发病六小时内椎-基底动脉系统缺血性卒中患者的疗效

被引：7

作者：

李慧英 ^{[1
]}

蒋初明 ^{[1
]}

袁丹 ^{[1
]}

李郁芳 ^{[2
]}

缪中荣 ^{[3
]}

机构：

[1] 北京航天总医院神经内科

[2] 北京航天总医院影像中心

[3] 首都医科大学宣武医院介入放射诊断治疗科

来源：

中国脑血管病杂志 | 2012年 / 9卷 / 04期

关键词：

椎底动脉供血不足; 卒中; 血栓溶解疗法; 血管成形术; 支架;

D O I：

暂无

中图分类号：

R743.3 [急性脑血管疾病（中风）];

学科分类号：

摘要：

目的探讨动脉内溶栓联合血管成形术治疗椎-基底动脉系统缺血性卒中6 h内患者的疗效及安全性。方法收集2006年4月—2012年2月椎-基底动脉系统急性缺血性卒中(发病时间<6 h)患者21例,根据所用治疗方式的不同分为单纯动脉内溶栓组(10例)和动脉内溶栓联合血管成形术组(联合治疗组,11例)。联合治疗组中4例行球囊扩张和支架置入术,1例行支架置入术,6例仅行球囊扩张术。根据急性心肌梗死溶栓标准(TIMI)判定血管再通情况。采用美国国立卫生院卒中评分(NIHSS)评价治疗前后的神经功能。根据改良Rankin量表(mRS)评估溶栓后3个月的疗效。结果①单纯溶栓组6例患者的血管再通,其中1例(10.0%)为完全再通,联合治疗组有7例血管再通,其中6例(54.5%)为完全再通,完全再通率差异有统计学意义,P<0.05。②经治疗后,单纯溶栓组和联合治疗组的NIHSS评分均下降,但是两组患者的术后即刻、术后24h和术后2周的NIHSS评分比较,组间差异无统计学意义。③两组均有3例患者死亡。治疗3个月后,存活的患者中,单纯溶栓组疗效良好的有4例,疗效差的有3例;联合治疗组分别为5例和3例。两组比较,病死率及疗效差异无统计学意义。④成功施行支架置入术的5例患者,血管均得到完全再通,术后随访未见再狭窄。而动脉溶栓联合单纯球囊扩张的6例患者中,仅2例获再通(1例为完全再通),其中1例术后3个月发生再狭窄。结论对于行单纯动脉内溶栓血管不能再通的椎-基底动脉系统急性缺血性卒中患者,联合血管内成形术可提高血管再通率;支架置入术较单纯球囊扩张术疗效可能更佳。

引用

页码：183 / 188

页数：6

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