超过 4.5 小时,还溶栓吗?
写在前面:感谢作者分享,幻灯片版权属于原作者,仅供学习交流使用。前方多图,建议在 WIFI 条件下阅读。
总结:
其实对于指南的突破,并不是去否定指南,而是去修订和完善指南。我们在临床实践中要尊重指南的推荐,目的是少走弯路,让患者能够最大程度地获益。
我们也要有突破指南的勇气,掌握突破指南的科学方法,这不仅能够推动临床研究站上新的台阶,更是为了让更多的患者得到更多的治疗机会。
11 月 11 日,在苏州市医学会神经病学专业委员会及脑卒中专业委员会、苏州大学附属第一医院卒中中心主办的首届姑苏脑卒中防治高峰论坛上,作者王辉与我们分享了这一精彩内容。感谢作者及主办方对神经时间的授权。
阅读推荐:
编辑 | 王弘
投稿及合作 | wanghong@dxy.cn
题图来源 | 站酷海洛
参考资料
神经时间
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[2]. Tan, M.A., et al., Low detection rate of craniocervical arterial dissection in children using time-of-flight magnetic resonance angiography: causes and strategies to improve diagnosis. J Child Neurol, 2009. 24(10): p. 1250-7.
[3].Berrouschot, J., et al., Outcome and severe hemorrhagic complications of intravenous thrombolysis with tissue plasminogen activator in very old (> or =80 years) stroke patients. Stroke, 2005. 36(11): p. 2421-5.
[4].Engelter, S.T., L.H. Bonati and P.A. Lyrer, Intravenous thrombolysis in stroke patients of > or = 80 versus < 80 years of age--a systematic review across cohort studies. Age Ageing, 2006. 35(6): p. 572-80.
[5].Selim, M., et al., Seizure at stroke onset: should it be an absolute contraindication to thrombolysis? Cerebrovasc Dis, 2002. 14(1): p. 54-7.
[6].Chalela, J.A., et al., Safety of intra-arterial thrombolysis in the postoperative period. Stroke, 2001. 32(6): p. 1365-9.
[7]. Demaerschalk, B.M., et al., Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke: A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke, 2016. 47(2): p. 581-641.
[8]. Goyal, N., et al., Systemic thrombolysis in acute ischemic stroke patients with unruptured intracranial aneurysms. Neurology, 2015. 85(17): p. 1452-8.
[9]. Morita, A., et al., The natural course of unruptured cerebral aneurysms in a Japanese cohort. N Engl J Med, 2012. 366(26): p. 2474-82.
[10].高峰, 魏晓娜与宋庭奕, 烟雾病并发急性脑梗死溶栓治疗成功案例举隅. 中国中西医结合急救杂志, 2017(4): 第435-436页.