血栓溶解治療在急性腦血管栓塞的應用

Thrombolytic Therapy for Acute Cerebro Vascular Thrombosis

陳啓昌(Chi-Chang Chen) ； 蔡芳洋(Fong Tsai)

《中華放射線醫學雜誌》 17卷4期 (1992/12) Pp. 391-398

摘要

對於急性腦血管栓塞的患者，以往經由全身性靜脈注射血栓溶解劑的治療，其效果有限且易併發出血。我們藉由血管攝影檢查將導管置於血管栓塞部位，以urokinase直接在動脈和靜脈竇內注射行血栓溶解治療，盼能有效溶解血栓恢復血流暢通並減少出血併發症發生。本文報告三例分別為脊椎動脈，內頸動脈，和靜脈竇栓塞的患者，接受動脈和靜脈竇內直接注射血栓溶解劑urokinase治療，後均見血栓溶解和患者臨床症狀明顯改善，因此我們認為此一治療對於此病患者為一可行且有效的方法。

關鍵字

血栓溶解治療 ； 血栓 ； 介入性放射線學

並列摘要

In an attempt to help patients who suffered from acute cerebrovascular thrombosis, systemic intravenous adminstration of the thrombolytic agent had been tried with limited effects but significant risks of cerebral hemorrhage. By means of angiographic technique, the tip of the catheter was put into the thrombi. Local intra-arterial or intra-sinus thrombolytic therapy with direct injection of urokinase was performed, in order to lyse the thrombi and stop the propagation of the thrombus and thus increase perfusion to the ischemic area. Besides, superselective arterial or sinus treatment reduced the complications from systemic application. Three patients, who had acute vertebral artery, internal carotid artery and venous sinus thrombosis respectively, underwent direct intra-arterial and/or intra-sinus urokinase injection. All achieved good recovery. Our results suggested this is a practical and effective way in the management of this kind of patients.

並列關鍵字

Thrombolysis ； thrombosis ； interventional procedures ； cerebral blood vessels, thrombosis