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溶栓后出血及口咽舌血管性水肿并发症的管理

Management of Postthrombolysis Hemorrhagic and Orolingual Angioedema Complications.

作者信息

O'Carroll Cumara B, Aguilar Maria I

机构信息

Department of Neurology, Division of Cerebrovascular Diseases, Mayo Clinic, Phoenix, AZ, USA.

出版信息

Neurohospitalist. 2015 Jul;5(3):133-41. doi: 10.1177/1941874415587680.

DOI:10.1177/1941874415587680
PMID:26288671
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4530424/
Abstract

Intravenous recombinant tissue plasminogen activator was first approved for the treatment of acute ischemic stroke in the United States in 1996. Thrombolytic therapy has been proven to be effective in acute ischemic stroke treatment and shown to improve long-term functional outcomes. Its use is associated with an increased risk of symptomatic intracerebral hemorrhage as well as orolingual angioedema. Our goal is to outline the management strategies for these postthrombolysis complications.

摘要

静脉注射重组组织型纤溶酶原激活剂于1996年在美国首次被批准用于治疗急性缺血性中风。溶栓治疗已被证明在急性缺血性中风治疗中有效，并显示可改善长期功能预后。其使用与症状性脑出血以及口咽血管性水肿的风险增加有关。我们的目标是概述这些溶栓后并发症的管理策略。

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本文引用的文献

1
Symptomatic intracerebral hemorrhage in acute ischemic stroke after thrombolysis with intravenous recombinant tissue plasminogen activator: a review of natural history and treatment.静脉注射重组组织型纤溶酶原激活剂溶栓后急性缺血性卒中的症状性脑出血：自然史与治疗综述
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2
Different doses of recombinant tissue-type plasminogen activator for acute stroke in Chinese patients.不同剂量重组组织型纤溶酶原激活剂治疗中国急性脑卒中患者的疗效。
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Orolingual angioedema after alteplase therapy of acute ischaemic stroke: incidence and risk of prior angiotensin-converting enzyme inhibitor use.急性缺血性脑卒中阿替普酶治疗后口腔-舌血管性水肿：发生率及血管紧张素转换酶抑制剂使用史的风险。
Eur J Neurol. 2014 Oct;21(10):1285-91. doi: 10.1111/ene.12472. Epub 2014 Jun 9.
4
Remote or extraischemic intracerebral hemorrhage--an uncommon complication of stroke thrombolysis: results from the safe implementation of treatments in stroke-international stroke thrombolysis register.远程或缺血性外脑出血——溶栓治疗后卒中的一种罕见并发症：来自卒中溶栓国际登记研究中安全实施治疗的结果。
Stroke. 2014 Jun;45(6):1657-63. doi: 10.1161/STROKEAHA.114.004923. Epub 2014 May 1.
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Onset of Orolingual Angioedema After Treatment of Acute Brain Ischemia with Alteplase Depends on the Site of Brain Ischemia: A Meta-analysis.急性脑缺血使用阿替普酶治疗后口咽血管性水肿的发作取决于脑缺血部位：一项荟萃分析
N Am J Med Sci. 2013 Oct;5(10):589-93. doi: 10.4103/1947-2714.120794.
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Serum creatinine may indicate risk of symptomatic intracranial hemorrhage after intravenous tissue plasminogen activator (IV tPA).血清肌酐可能提示静脉注射组织型纤溶酶原激活剂（IV tPA）后出现症状性颅内出血的风险。
Medicine (Baltimore). 2013 Nov;92(6):317-323. doi: 10.1097/MD.0000000000000006.
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Low-dose tissue plasminogen activator and standard-dose tissue plasminogen activator in acute ischemic stroke in Asian populations: a review.低剂量组织型纤溶酶原激活剂与标准剂量组织型纤溶酶原激活剂治疗亚洲人群急性缺血性脑卒中：系统评价。
Cerebrovasc Dis. 2013;36(3):161-6. doi: 10.1159/000354162. Epub 2013 Oct 12.
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Safety of thrombolysis in acute ischemic stroke: a review of complications, risk factors, and newer technologies.急性缺血性卒中溶栓治疗的安全性：并发症、危险因素及新技术综述
Neurohospitalist. 2011 Jul;1(3):138-47. doi: 10.1177/1941875211408731.
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Complications associated with recombinant tissue plasminogen activator therapy for acute ischaemic stroke.与重组组织型纤溶酶原激活剂治疗急性缺血性脑卒中相关的并发症。
CNS Neurol Disord Drug Targets. 2013 Mar;12(2):155-69. doi: 10.2174/18715273112119990050.
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Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.急性缺血性脑卒中患者早期管理指南：美国心脏协会/美国卒中协会医疗保健专业人员指南。
Stroke. 2013 Mar;44(3):870-947. doi: 10.1161/STR.0b013e318284056a. Epub 2013 Jan 31.