Thrombolytic therapy of acute cerebral infarction

ncycgdxhl · Wysłany: Pon 10:13, 21 Mar 2011

Thrombolytic therapy of acute cerebral infarction Issues

Capacity and technical equipment. 5.2 Contraindications 5.2.1 before tying solution rapidly improved symptoms and signs; onset seizures with Nan lame and can not control the symptoms of those who can not score a single neurological deficit, such as ataxia or sensory disorders. 5.2.2 Cerebral hemorrhage; 3 October infarction and cerebral trauma in the history of aiming left defect was successful crisp. 5.2.3 serious heart, liver,[link widoczny dla zalogowanych], renal medullary no barrier; recent myocardial infarction; surgery and childbirth retention within six months of active ulcer within 3 weeks of road throughout the gastrointestinal or urinary tract bleeding or with known bleeding tendencies. 5.2.4 anticoagulant in patients with heart; clotting alcohol original time (PPT)> 15l liver disease used 48 hours before the extension cord so pPT {platelets 400mS/dl {baseline SBP> 24.7-26.7kPa (185 - 200mmI ~). DBP ~> I2.7--16kPa (1】 O a 120mmI ~). 5.2.5 carotid occlusion with coma. 6 Cao suppository in the treatment of concurrent Ya-processing three major complications: hemorrhage, cerebral ischemia from edema and vascular injection and then closed. There are allergic reactions to drugs again, stroke (including wall plaque from the caused by embolism) and so on. 6.1 bleeding. Mainly intracranial hemorrhage (IVC ancient spider A pancreatic or brain hemorrhage.) Rate was 4-26% range. Mortality rate of up to 5O%. Fan Gui common in the beginning 6 hours in the pathogenesis of the latter, generally occurred in the treatment of blood pressure after 24 hours {24-26.7/13.3-16kPa (18O a 200 / obstruct Fort Hall Fort Wong plug wall 998 l volume】 4 100 - 120mmHg); head CT have shown that the corresponding low density and symptoms; aged> 65 years; the various items of the bleeding rate than those without these three times because of cable. Which accounted for 46 basal ganglia hemorrhage,[link widoczny dla zalogowanych], cerebral hemorrhage accounted for 31t leaves were 15 infarct hemorrhage (hemorrhagic infarction), but also for other organs bleeding. General disturbance of consciousness after thrombolysis, increased bleeding should be considered in combination, should urgently check CT was confirmed in an immediate withdrawal bleeding, blood tests of the project, prepare red blood cells, platelets, fresh plasma or whole blood ice pick alternate, if necessary brain surgery consultation . Are indications for surgery in the fibrinolysis before surgery and for recovery related to symptomatic treatment. 6.2 to reperfusion-induced brain edema. This is an important complication of thrombolytic therapy, the current study fork ~ hot spots. Increased intracranial pressure can lead to life-threatening. Should be taken to dehydration, and other measures to reduce intracranial pressure foot. Male lip clear set of oxygen free radicals outside agent (such as mannitol, hormone living index E, vitamin c, etc.), calcium antagonists (such as Nigeria really equal) can be re-occlusion of vascular clinical application of 6.3. Rate was l0-2O, the exact cause is not known. 7, several other issues related to thrombolytic effect of 7.1 of factors: mainly from the onset to the start of thrombolytic therapy when asked, thrombolytic pathway, and blood clots the size of drug selection, dosage site of arterial occlusion, thrombus type body temperature. For experiment suggested that mild hypothermia (32c) can reduce infarct size, play a role in protecting the brain, but no proof of an improvement in dissolved ji5i tied to reports of efficacy. 7.2 antithrombotic and antiplatelet agents, and: The experiment of aspirin (ASA) of t-PA solution is tied to lack of evidence after the bleeding. t-PA hepatic artery wells tied to cable melting,[link widoczny dla zalogowanych], melting pass rate may increase, but also increased the risk of bleeding, and some academics have suggested a dose-related. Had taken ASP. Patients, if the other conditions of qualified candidates for t-PA can still swim suppository. Used warfarin hepatic cord or extension of a taboo if the clotting factor. t-PA within 24 hours of thrombolytic therapy disable all antithrombotic and antiplatelet drugs. In summary, in recent years because the pathophysiology of cerebral infarction, neurological imaging and pharmacological studies have advanced, published a number of international higher Fu Tong reports. Undoubtedly thrombolytic therapy of acute cerebral infarction showed an optimistic outlook. In China thrombolytic therapy of acute ischemic stroke has just started. Xia is still in the research stage. Despite the bright future of early thrombolysis,[link widoczny dla zalogowanych], but the ratio of the risk and efficacy need to clear, it should be cautious, the current 95 cerebrovascular disease as a national research project is being organized to study a number of hospitals can only be used in case of strict design clinical, not yet elected to the promotion level. The majority of national hospitals, as the case may be, to take practical treatment of acute cerebral infarction, cut so-called ultra-early laying herd thrombolysis. In order to avoid unnecessary adverse consequences. The main task of careful preparation,[link widoczny dla zalogowanych], waiting for normative conditions are ripe for thrombolytic therapy. ~ - R-T a - wide. Date of Singapore issued a Ol-16 1998 (edited September Ru) l-l (