Clinical observation of intra-arterial thrombolysis with recombinant tissue plasminogen activator in the treatment of early acute cerebral infarction

WANG Yi-cui; CHANG Huan-xian; KONG Ling-sheng

doi:10.3969/j.issn.1002-1949.2016.07.008

Abstract：Objective To observe the curative effect and security of intra-arterial thrombolysis with recombinant tissue plasminogen activator (r-TPA) in the treatment of early (attack time<6 h)acute cerebral infarction. Methods A total of 108 patients with early acute cerebral infarction were divided into two groups according to the digital table method. The observation group(54 cases, loss to follow-up 2 cases, complete 52 cases)was treated with r-TPA selective artery thrombolysis combined with interventional therapy in emergency department(Percutaneous intravascular embolectomy+Blood vessel forming+Stent implantation). The control group(54 cases, loss to follow-up 2 cases, complete 52 cases)was treated with simple r-TPA intravenous thrombolysis. To observe the efficacy, complica?tions and prognosis of the two groups were compared. Results The vascular patency rate of the observa?tion group was 100%, the complete rate of the observation group was higher than the control group(χ2=50.514, P<0.01). At preoperative, and 24 h, 7 d, 30 d, 3 months after surgery, the NIHSS scores in the observation group were all lower than those in the control group(all P<0.01). ADL scores were higher than those in the control group(all P<0.01). The incidence of bleeding in the observation group was lower than that in the control group(χ2=3.9829, P<0.05). Follow up at 3 months after operation, the recurrence rate of cerebral infarction in the observation group was lower than that in the control group (χ2=4.3789, P<0.05). Conclusion In the treatment of patients with early cerebral infarction,intra-arterial thrombolysis combined with endovascular treatment is superior to intravenous thrombolysis alone, improve the vascular patency rate significantly, reduce the bleeding rate, and improve the prognosis.