The Clinical Study On Implanting Intraarterial Catheter For The Treatment Of Acute Cerebral Infarction

Objective : Cerebrovascular diseases have high morbidity, mortality, mutilation rate and recurrence rate, about two third of which is cerebral infarction. Acute cerebral infarction is one of the acute, high risky and severe diseases in internal medicine. Reasonable, effective treatment is important to the prognosis. There are many studies on the treatment, but pharmacotherapy is the main method in the acute phase. Intravenous drip is the main administration route (AR) for the hospitalized patients, while the report of interventional implanting intraarterial catheter (IAAC) administration route is few. It has critical guidance significance through rational right AR. From the clinical perspective, we investigate the therapeutic effect and safety of the IAAC treatment through the contrast between the intravenous drip group and the IAAC treatment group.Methods: A total of 60 patients with acute stroke who presented within 3 days of onset were enrolled. They were divided into two groups, which were called observation group and control group with 30 cases respectively. The observation group accepted the IAAC treatment, while the control group accepted the routing intravenous drip. The NIHSS scores of the two groups were: observation group 9.5±5.6247, control group 9.3±5.100. There was no statistical significance between the two groups in the degree of the neurologic impairment, gender, age, incidence, cerebral infarction type. In another word, the two groups had statistical comparability. Gave symptomatic treatment and accounted the numbers to the patients with hypertension, hyperlipoidemia, diabetes mellitus, or other diseases. The same sorts and dosages were used in the cases selected. But the AR had some differences in ginkgo biloba injection(GBI) and cytidine disodium triphosphate injection(CDTI). Routing intravenous drip was used in the control group, while the IAAC treatment in the observation group. Seldinger technique was performed in the femoral artery at the uninjured side in the observed group. After cerebral angiography, kept the catheter intraaterial detained and made it sure that the tip of the catheter was as near as it could to the main blood-supply artery of the responsible foci. GBI and CDTI were slowly infused through the catheter once each day. Assuring the catheter was unobstructed when pumpbacking was very important. Otherwise administration was forbidden. In this situation, reset the direction of the catheter. Infused the drugs until it was unobstructed. Heparin diluted with saline was used to infuse the catheter after the performance, and covered the area sterily. Before the administration, observed the area to exclude displace of the catheter and red, edema of the incision. And we observed the condition of the patient to judge if there was mouth dryness, heat sensation, or some other nonsense reaction during the processing. The NIHSS was performed on the first day, forth day and seventh day during the trial.Calculated the average xand standard deviation s of different groups. t test was done between two groups necessary.Results: In the observation group, 30 cases contained, male 19, female 11 among them, and the average age 58.3±11.2. In the control group, 30 cases contained, male 17, female 13 among them, and the average age 59.6±9.6. There were hypertension cases 42(70%), hyperlipoidemia cases 31(51.7%), diabetes mellitus cases 18(30%), hypertension with diabetes mellitus cases 9(15%), hypertension with hyperlipoidemia cases 22(36.7%), hyperlipoidemia with diabetes mellitus cases 11(18.3%), hypertension together with hyperlipoidemia and diabetes mellitus cases 5(8.3%), cases without hypertension, hyperlipoidemia and diabetes 2(3.33%). There was no complication in the observation group.The t test was done between the requested teams on the 1std, 4thd and 7thd, and found that p<0.05, which showed that statistical significance was existed. The t test performed between the 1std, and 7th.d p<0.05, while between the 1std and 4thd, 4thd and 7thd p>0.05 which showed that statistical significance was not existed. The t test performed between the 1std, 4thd, and 7thd p<0.05, which showed that statistical significance was existed.Conclusions:1. IAAC treatment was better than traditional routing intravenous drip, and it was safe. Because of the small sample, the validity needs to be verified through large sample in future.2. GBI and CDTI were effective to acute cerebral infarction.