Hirano Teruyuki
Department of Neurology, Oita University Faculty of Medicine, Yufu, Oita, Japan.
Neurol Med Chir (Tokyo). 2013;53(8):531-6. doi: 10.2176/nmc.53.531.
Ischemic stroke is uncommon during pregnancy, but decision making for acute revascularization therapy including intravenous recombinant tissue plasminogen activator (rt-PA) is difficult. The use of rt-PA remains controversial, but a systematic review of 16 patients (mean age 31.7 years) showed good results for both maternal (77.8%) and fetal (56.3%) outcomes. Pregnancy alone is not a solid contraindication for acute revascularization therapy including rt-PA. An endovascular approach might be beneficial for reducing the hemorrhagic complication; however, the treatment strategy should be considered based on the available treatment facility. Close cooperation with obstetrics is essential for the successful management of saving the lives of both the mother and the fetus.
缺血性中风在孕期并不常见，但对于包括静脉注射重组组织型纤溶酶原激活剂（rt-PA）在内的急性血管再通治疗进行决策却很困难。rt-PA的使用仍存在争议，但一项对16例患者（平均年龄31.7岁）的系统评价显示，产妇（77.8%）和胎儿（56.3%）的预后均良好。单纯妊娠并非包括rt-PA在内的急性血管再通治疗的绝对禁忌证。血管内治疗方法可能有助于减少出血并发症；然而，应根据现有的治疗设备来考虑治疗策略。与产科密切合作对于成功挽救母亲和胎儿的生命至关重要。
