Đánh giá hiệu quả và tính an toàn của điều trị tiêu sợi huyết đường tĩnh mạch liều thấp trên bệnh nhân đột quỵ cấp trong cửa sổ 0-3 giờ

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Tác giả: Huy Thắng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 362.19681 Physical illness

Thông tin xuất bản: Y học Việt Nam, 2018

Mô tả vật lý: 180-183

Bộ sưu tập: Metadata

ID: 541174

Thêm vào giỏ

Background and objectives: To compare the efficacy and safety of low dose alteplase with standard dose for intravenous thrombolysis in stroke patients. Methods: A prospective study of all acute stroke patients treated with intravenous fibrinolysis under the protocol of the NINDS study, initial NIHSS score at admission and mRS assessment at age score of 3 months, followed by systemic haemorrhagic events and cerebral haemorrhage resulting from fibrinolysis. Results
Of 6171 stroke patients hospitalized for 3 years follow-up, only 121 patients (2%) were treated ith intravenous fibrinolysis. The median age was 57 years, mean NIHSS score was 12. The time from onset of symptoms to folic acid was 143 minutes (50 minutes at the earliest and 210 minutes at the earliest). Of these, 73 were treated with standard rtPA and 48 were low-dose (mean 0.62mg/kg). The prevalence of mRS from 0 to 1 in the low-dose treatment group was 56.3% higher compared to 34.2% in the standard treatment group. Mortality rates in the standard treatment group were also higher than those in the low dose group (12.5% vs. 2.1% P = 0.004). Four cases of symptomatic cerebral hemorrhage were reported in the standard treatment group compared with only one patient in the low-dose group (P =0.36). Conclusion: Intravenous fibrinolytic therapy with low dose of rtPA is superior than standard dose for acute stroke patients in the selective population of Vietnam.Đánh giá hiệu quả và tính an toàn của điều trị tiêu sợi huyết đường tĩnh mạch liều thấp trên 6171 bệnh nhân đột quỵ cấp trong cửa sổ 0-3 giờ tại bệnh viện Nhân dân 115. Kết quả cho thấy trong tổng số 6171 bệnh nhân, chỉ có 121 bệnh nhân được điều trị tiêu sợi huyết tĩnh mạch. Thời gian từ lúc khở phát triệu chứng đến khi được điều trị tĩnh mạch là 143 phút. Trong 121 bệnh nhân, có 73 người được điều trị với liều rtPA chuẩn, còn lại 48 bệnh nhân được sử dụng liều thấp. Tỷ lệ bệnh nhân mRS từ 0-1 ở nhóm điều trị liều thấp là 56,3%, cao hơn so với nhóm điều trị liều cao (34,2%). Tỷ lệ tử vong ở nhóm điều trị liều chuẩn cũng cao hơn so với nhóm bệnh nhân điều trị liều thấp.

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