Objective To analyze the clinical efficacy of ultra-early interventional thrombolytic therapy in large hemisphere infarction and its effects on patients’ cerebral hemodynamics and cerebral oxygen metabolism.Methods Ninety-six patients with large hemisphere infarction admitted to a hospital in Luohe City from June 2018 to June 2020 were selected as subjects and divided into a control group（treated with intravenous thrombolysis） and a study group（treated with ultra-early interventional thrombolysis）

with 48 subjects in each group

and both groups were treated continuously for 7 d.The clinical efficacy

recanalization rate and complications of the occluded vessels were compared between the two groups

and the cerebral hemodynamics [peak velocity（Vp）

mean velocity（Vm） and differences of the velocity（DVp

DVm） of the middle cerebral artery bilaterally]

cerebral oxygen metabolism [arterial oxygen content（CaO

2

）

arterial-venous oxygen content difference [D（a-jv）O

2

cerebral extraction rate of oxygen（ERO

2

）] were compared between the two groups before and after treatment.Results The total effective rate of treatment was higher in the study group than in the control group（95.83% vs.77.08%）

and the difference was statistically significant（P

<

0.05）.DVp

DVm

CaO

2

ERO

2

and D（a-jv）O

2

levels after treatment were lower in both groups than before treatment

with indicators lower in the study group than in the control group.Vp and Vm increased compared with pre-treatment and were higher in the study group than those in the control group

and the difference was statistically significant（P

<

0.05）.The recanalization rate of patients in the study group was higher than that in the control group

and the difference was statistically significant（P

<

0.05）.The incidence of complications during treatment was lower in the study group than in the control group

and the difference was statistically significant（P

<

0.05）.Conclusion The clinical efficacy of ultra-early interventional thrombolytic therapy in patients with large hemisphere infarction can significantly improve the rate of revascularization and promote cerebral hemodynamics and cerebral oxygen metabolism

and the incidence of complications is low

which is worth promoting in clinical practice.