Varga Viktoria, Waje-Andreassen Ulrike, Naess Halvor, Lundstadsveen Maria Therese, Thomassen Lars
Nevrologisk avdeling, Haukeland universitetssykehus, 5021 Bergen, Norway.
Tidsskr Nor Laegeforen. 2009 Nov 5;129(21):2214-7. doi: 10.4045/tidsskr.08.0093.
Intravenous thrombolysis has gained widespread acceptance during the last 10 years, and is the only specific treatment approved for cerebral infarction. Haukeland University hospital introduced thrombolysis in 1998. The aim of this paper is to summarize our experience with the first 100 patients who had stroke caused by middle cerebral artery (MCA) occlusion and were treated with thrombolysis.
Patients receiving intravenous thrombolytic treatment between 1998 and 2005 were prospectively included into our database. We registered demographic data, risk factors, time aspects, short and long-term clinical results and complications.
Two hours after treatment, a definite clinical improvement was recorded in 30 % of patients, and after 24 hrs in 49 % of the patients. Symptomatic haemorrhages were seen in 2 % of the cases. Three patients underwent haemicraniectomy because of malignant cerebral oedema and danger of hernia. At three months follow-up, 55 % of the patients had a good outcome (independence), while 13 % were dead. Time from stroke onset to start of thrombolysis was reduced from 166 to 142 min during the study period.
The results for the first 100 acute MCA stroke patients treated with thrombolysis in Haukeland University Hospital compare well with international data, both for clinical outcome and complications. Our results thereby support the notion that intravenous thrombolysis is effective and safe when applied as a routine treatment in a comprehensive stroke unit.
在过去十年中，静脉溶栓疗法已得到广泛认可，并且是唯一被批准用于脑梗死的特异性治疗方法。豪克兰大学医院于1998年引入了溶栓疗法。本文的目的是总结我们对首批100例因大脑中动脉（MCA）闭塞导致中风并接受溶栓治疗的患者的经验。
前瞻性地将1998年至2005年间接受静脉溶栓治疗的患者纳入我们的数据库。我们记录了人口统计学数据、危险因素、时间因素、短期和长期临床结果以及并发症。
治疗两小时后，30%的患者出现明确的临床改善，24小时后这一比例为49%。2%的病例出现症状性出血。三名患者因恶性脑水肿和脑疝风险接受了去骨瓣减压术。在三个月的随访中，55%的患者预后良好（独立生活），而13%的患者死亡。在研究期间，从中风发作到开始溶栓的时间从166分钟缩短至142分钟。
豪克兰大学医院首批100例接受溶栓治疗的急性MCA中风患者的结果在临床结局和并发症方面与国际数据相比良好。因此，我们的结果支持了这样一种观点，即静脉溶栓作为综合卒中单元的常规治疗方法是有效且安全的。
