Wang Hui-Xiao, Shen Yi-Jin, Ye Shu-Jun, Xu Yong-Kang, Zhang Jian-Pin, Lu Zhou
Department of Neurosurgery, Affiliated Yinzhou Hospital, College of Medicine, Ningbo University, Ningbo, Zhejiang 315040, P.R. China.
Exp Ther Med. 2013 May;5(5):1444-1450. doi: 10.3892/etm.2013.990. Epub 2013 Mar 6.
The aim of this study was to assess the clinical efficacy and safety of mechanically assisted thrombolysis in the treatment of acute cerebral infarction. Mechanically assisted intra-arterial urokinase thrombolysis was conducted on 28 patients with acute cerebral infarction with a disease onset time of 90-450 min. The maximum level of urokinase was 1,150,000 units. Thrombus disruption with a microwire, retrieval with a microcatheter and stent-assisted revascularization were performed. The recanalization rate, bleeding complications and modified Rankin scale (mRS) score were observed within 3 months of surgery. Our results showed that mechanically assisted thrombolysis was successfully conducted on 23 patients, with a recanalization rate of 82.1% (23/28), average recanalization time of 65.22 min and mRS score ≤3.5. Five cases of recanalization were invalid, including 2 cases of mortality, 1 case with an mRS score of 4 and 2 cases with an mRS score ≤3. In the recanalization group, the mechanically assisted thrombolysis did not increase the number of bleeding complications. Our study demonstrated that the safety of mechanically assisted thrombolysis for the treatment of acute cerebral infarction is equivalent to that of simple intra-arterial thrombolysis, but that the former has a higher efficiency. Mechanically assisted thrombolysis is able to reduce the urokinase dosage and recanalization time, and increase the recanalization rate.
本研究旨在评估机械辅助溶栓治疗急性脑梗死的临床疗效和安全性。对28例发病时间为90 - 450分钟的急性脑梗死患者进行了机械辅助动脉内尿激酶溶栓治疗。尿激酶最大用量为1150000单位。采用微导丝进行血栓破碎、微导管取栓及支架辅助血管再通。观察术后3个月内的再通率、出血并发症及改良Rankin量表（mRS）评分。结果显示，23例患者成功进行了机械辅助溶栓，再通率为82.1%（23/28），平均再通时间为65.22分钟，mRS评分≤3.5。5例再通无效，包括2例死亡、1例mRS评分为4和2例mRS评分≤3。在再通组中，机械辅助溶栓未增加出血并发症的数量。我们的研究表明，机械辅助溶栓治疗急性脑梗死的安全性与单纯动脉内溶栓相当，但前者效率更高。机械辅助溶栓能够减少尿激酶用量和再通时间，并提高再通率。
