Rauber K
Röntgenabteilung, Kliniken der Justus-Liebig-Universität Giessen.
Z Gesamte Inn Med. 1993 Jun-Jul;48(6-7):344-50.
Systemic as well as local applications of thrombolytic agents can both be used in the treatment of arterial occlusive disease. Systemic thrombolysis yields the best results in recent arterial occlusions, while local intrathrombotic infusion of thrombolytic agents is also effective in chronic occlusions. In Germany the ultra-high-dose short-term infusion of streptokinase is widely used in systemic thrombolytic therapy. Urokinase and rt-PA are used in local thrombolytic therapy, because they show fewer side effects than streptokinase. The advantages of local thrombolytic therapy as compared to systemic infusions are a higher success rate, immediate angioplasty of underlying arterial stenoses during one procedure, and the demand for lower doses of thrombolytic agents. Despite the broad application of both techniques in current clinical practice there are virtually no comparative studies of both methods, nor are there studies that compare thrombolytic therapy with other revascularisation procedures (i.e. angioplasty, surgery).
溶栓剂的全身应用和局部应用均可用于治疗动脉闭塞性疾病。全身溶栓在近期动脉闭塞中效果最佳，而局部血栓内注入溶栓剂在慢性闭塞中也有效。在德国，超大量短期输注链激酶广泛用于全身溶栓治疗。尿激酶和重组组织型纤溶酶原激活剂用于局部溶栓治疗，因为它们比链激酶副作用少。与全身输注相比，局部溶栓治疗的优点是成功率更高、在一次手术中可对潜在的动脉狭窄立即进行血管成形术以及所需溶栓剂剂量更低。尽管这两种技术在当前临床实践中都有广泛应用，但实际上几乎没有对这两种方法进行比较的研究，也没有将溶栓治疗与其他血管重建手术（即血管成形术、手术）进行比较的研究。
