目的　评价超早期选择性脑动脉溶栓疗法 (SIT)对急性缺血性脑卒中的疗效及安全性。方法　 32例急性缺血性脑卒中患者起病至溶栓时间介于 1～ 6小时。尿激酶用量 87 6 6± 17 6 3万单位。溶栓前先用微导丝通过血栓到达血栓远端 ,导丝撤出后 ,将导管置于靶血管闭塞点或患侧颈内动脉进行溶栓治疗。结果　颈内动脉闭塞 12例 ,3例完全再通 ,2例部分再通。大脑中动脉闭塞 2 0例 ,19例完全再通。治疗后 3个月神经功能恢复率为 81% (2 6 /32 )。 4例合并无症状性脑出血均痊愈。血管再闭塞 1例 (经重复造影证实 )。结论　超早期SIT治疗可使闭塞血管再通。溶栓后并发无症状性脑出血患者临床可恢复正常。SIT是目前治疗急性缺血性脑卒中有效的治疗手段。 Objective To evaluate the efficacy and safety of ultra-early selective cerebral artery thrombolysis (SIT) in patients with acute ischemic stroke. Methods 32 patients with acute ischemic stroke onset to thrombolytic time between 1 to 6 hours. Urokinase dosage 87 6 6 ± 17 6 ​​30 000 units. Before thrombolysis with micro-guide wire through the thrombus to the distal thrombus, guide wire withdrawal, the catheter placed in the target vessel occlusion or ipsilateral internal carotid artery thrombolytic therapy. Results Internal carotid artery occlusion in 12 cases, 3 cases completely recanalization, 2 cases recanalization. Middle cerebral artery occlusion 20 cases, 19 cases completely recanalization. Three months after treatment, the recovery rate of nerve function was 81% (26/32). 4 cases of asymptomatic intracerebral hemorrhage were cured. One case of vascular reocclusion (confirmed by repeat angiography). Conclusion Ultra-early SIT treatment can lead to recanalization of occluded vessels. Thrombolytic patients with asymptomatic cerebral hemorrhage may return to normal. SIT is currently an effective treatment for acute ischemic stroke.