内科

目的观察超选择性动脉溶栓治疗颈内动脉系统老年急性脑梗死（acute ischemic infarction，ACI）的效果，评价发病3～6 h内动脉溶栓和发病3 h内静脉溶栓治疗急性脑梗死的疗效和安全性。方法回顾性分析33例发病6 h内的老年急性脑梗死患者的临床资料，其中动脉溶栓组（发病3～6 h内）18例患者给予尿激酶动脉溶栓治疗，静脉溶栓组（发病3 h内）15例患者给予尿激酶静脉溶栓治疗。对比分析两组患者治疗前和治疗后3 h、24 h、14 d的美国国立卫生研究院卒中量表（NIHSS）评分，治疗前及治疗后7 d和90 d的Barthel（BI）评分，并观察不良反应。结果两组患者治疗后3 h、24 h、14 d的NIHSS评分和治疗后7 d、90 d的BI指数评分均较治疗前改善，差异有统计学意义（P＜0.05）；两组间比较各时间点NIHSS评分和BI评分及不良反应发生率无统计学差异（P＞0.05）。结论动脉溶栓治疗老年急性脑梗死的近期疗效和远期预后均与静脉溶栓治疗相当。

ObjectiveTo investigate the effect of superselected intraaterial thrombolysis on elderly patients with acute cerebral infarction in intracervical artery system, the efficiency and safety of intra-arterial thrombolysis therapy within 3 to 6 hours and intravenous thrombolysis therapy within 3 hours after onset of acute cerebral infarction were evaluated. MethodsThe clinical data of 33 elderly patients with acute cerebral infarction who onset within 6 hours were retrospectively analyzed, 18 patients were treated with intra-arterial thrombolysis using urokinase(onset within3-6 h, intraaterial thrombolysis group) ,15 patients were treated with intravenous thrombolysis using urokinase(onset within 6h, venous thrombolysis group). The NIHSS score of two groups were evaluated before and after thrombolysis 3h、24h、14 d,the Barthel Index (BI) of two groups were evaluated before and after thrombolysis 7 d、90d, and adverse reactions were also observed in both groups. ResultsThe NIHSS score at 3h, 24h, 14 d and the Barthel Index at 7 d, 90d improved significantly after treatment, there was significant difference before and after thrombolysis(P＜0.05).There was no significant difference in NIHSS score and Barthel Index between the two groups at each time point, and the incidence of adverse reactions in two groups had no statistically significant(P＞0.05). ConclusionsThe intra-arterial thrombolysis have the same efficacy in short-term effect and long-term prognosis as intravenous thrombolysis after acute cerebral infarction.