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[基底动脉溶栓:萨尔州卒中登记处的5年结果]

[Thrombolysis of the basilar artery: 5-year results from the Saarland stroke registry].

作者信息

Grunwald I Q, Struffert T, Roth C, Papanagiotou P, Scheuermann J, Voges M, Reith W

机构信息

Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes Homburg, Homburg/Saar.

出版信息

Radiologe. 2005 May;45(5):448-54. doi: 10.1007/s00117-005-1221-2.

Abstract

Acute thrombosis of the basilar artery has a fatal outcome if left untreated. The relatively good prognosis with intra-arterial thrombolysis makes it the therapy of choice for acute basilar thrombosis. In the Saarland stroke registry, we analyzed 47 patients with angiographically proven basilar artery thrombosis within the last 5 years. We observed a better outcome in patients with good income, with recanalization, and a short time between onset of symptoms and start of thrombolysis. The complications, such as intracerebral bleedings, occurred only in the group treated with rt-PA. Intra-arterial thrombolysis with urokinase or rt-PA is a relatively safe therapy, but should be performed in neuroradiological centers. With progressing symptoms the therapeutic window can be stretched up to 12 h, but coma lasting for more than 4 h is related to a bad outcome.

摘要

基底动脉急性血栓形成若不治疗会导致致命后果。动脉内溶栓预后相对较好,使其成为急性基底动脉血栓形成的首选治疗方法。在萨尔州卒中登记处,我们分析了过去5年内47例经血管造影证实为基底动脉血栓形成的患者。我们观察到,收入状况良好、实现再通且症状发作至溶栓开始时间较短的患者预后较好。脑出血等并发症仅发生在接受rt-PA治疗的组中。用尿激酶或rt-PA进行动脉内溶栓是一种相对安全的治疗方法,但应在神经放射学中心进行。随着症状进展,治疗窗可延长至12小时,但昏迷持续超过4小时与不良预后相关。

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