The experience about the th rom bolys is for the cerebral infarction by rT-PA in China
Object: To introduce our experience of therapy with T-PA in cerebral infarction in China, contraposed to a French document with a series of 100 cases. Methods: Inclusion criteria were same with Trouillas” protocol. Location attached was limited within the territory of internal carotid artery (ICA). The dose of rT-PA was 0.8-0.85mg/Kg. An initial bolus of 10% of the total dose was infused before 90% of the total dose was dropped byvein over 90 minutes. Calcic Nadroparin was continued after 12 hours ofthrombolysis for 10 days. At same time, 20% of Marnitol was administed according to the disorder state. The Scandinavia Stroke Score (SSS) were utilized to evaluate to the neurological function impaired before and after treatment for 24 hours, one week, one month and 3 months and modified Rankin′s Score (mRS) to the capability of life when 90 days after the treatment.Results: (1) Total 16 cases, who come from Shanghai of China, 8 cases of male and 8 cases of female, with 68.44±7.63 years old, were observed. The mean interval is 278.44±73.73 minutes. There are no significant different for baseline SSS, SSS at day 1, Day 7, Day 30 and Day 90 between our data and the data published. (P ＞0.05) In our group, there are 5 cases (31.25%) with absolute recovery, 4 cases (25%) with remarkable sequels, 2 cases with incapability himself because obvious sequels and 5 cases died in this group. Our study result is no difference with the document observed on Lyon of French. (P ＞0.05 ) (2) There are 10 cases of baseline SSS＜20. In this subgroup, the prognosis is significant difference with 6 cases of subgroup of baseline SSS ＞20. (P ＜0.05) The worse the SSS of baseline was, the worse prognosis is. No evidence of hemorrhage in the CT scans. It is important causes that result in bad prognosis: serious heart failure and cerebral infarction with great territory. (3) There are 5 cases died in our group. Among them, 60% died within 72 hours and 2 cases died at 4th day. The area of cerebral infarction is so big that severe cerebral edema presented in 3 cases of death. One case was with heart failure and another with unclear cause of death. All of them have no evidence of hemorrhage attested by CT scan. It is suggested that the cause of death is no relationship with bleeding after treatment ofrT-PA in our group. (4) In our study, there are 4 cases with slight gingiva bleeding without treated especially. Because of modificatory nose bleeding, the thrombolysis was had to stopped in 1 case. Conclusion: The rT-PA is can be utilized to treat the patient with cerebral infarction in China. The condition of baseline is an important caution for thrombolyse.
cerebral infarction、cause of death、heart failure、internal carotid artery、cerebral edema、CT scan
8
R74;R3
2005-07-07（万方平台首次上网日期，不代表论文的发表时间）
共1页
17
