妊娠期缺血性卒中的溶栓治疗：一例病例报告及文献综述
Thrombolysis for Ischemic Stroke during Pregnancy: A Case Report and Review of the Literature.
作者信息
Tversky Steven, Libman Richard B, Reppucci Marina L, Tufano Andrea M, Katz Jeffrey M
机构信息
Northwell Health, Great Neck, New York.
Northwell Health, Great Neck, New York.
出版信息
J Stroke Cerebrovasc Dis. 2016 Oct;25(10):e167-70. doi: 10.1016/j.jstrokecerebrovasdis.2016.06.023. Epub 2016 Aug 11.
BACKGROUND AND PURPOSE
Our knowledge of the safety of thrombolytic therapy in pregnancy stems from individual case reports and series. We report the successful use of intravenous alteplase (tissue plasminogen activator; tPA) thrombolysis in a pregnant woman with acute cardioembolic stroke presumed to be paradoxical embolism through a patent foramen ovale.
METHODS
A literature review found several case reports and case series of pregnant patients treated with either intravenous or intra-arterial tPA for acute ischemic stroke.
RESULTS
A literature review yielded 10 cases of intravenous tPA administration and 5 cases of intra-arterial tPA. In total, there were 3 cases of asymptomatic intracerebral hemorrhage and 1 case of maternal and fetal death.
CONCLUSIONS
Our patient improved clinically with no residual deficits. There was no evidence of placental or fetal injury following administration of tPA on follow-up obstetrical evaluations.
背景与目的
我们对妊娠期溶栓治疗安全性的了解源于个别病例报告及病例系列研究。我们报告了一名患有急性心源性脑栓塞的孕妇成功使用静脉注射阿替普酶（组织型纤溶酶原激活剂；tPA）进行溶栓治疗，该栓塞被推测为通过未闭卵圆孔的反常栓塞。
方法
文献综述发现了几例关于使用静脉或动脉内tPA治疗急性缺血性卒中的妊娠患者的病例报告和病例系列。
结果
文献综述得出10例静脉注射tPA病例和5例动脉内注射tPA病例。总共有3例无症状性脑出血以及1例母婴死亡。
结论
我们的患者临床症状改善且无残留缺陷。在后续产科评估中，未发现使用tPA后有胎盘或胎儿损伤的证据。
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