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題名 | 低劑量靜脈tPA血栓溶解治療在中風病人的效果及安全性=The Efficacy and Safety of Intravenous Low Dose Tissue Plasminogen Activator (tPA) Therapy in Stroke Patients |
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作者 | 陳浩榕; 黃永銓; 黃心樂; 陳媚娟; 蘇惠珍; 劉益宏; 張達人; 連立明; 陳威宏; 葉建宏; 邱浩彰; 侯勝茂; Chen, Hao-jung; Huang, Yung-chuan; Huang, Shin-leh; Chen, Mei-chuan; Su, Huei-chen; Liu, Yi-hung; Chang, Ta-jen; Lien, Li-ming; Chen, Wei-hung; Yeh, Jiann-horng; Chiu, Hou-chang; Hou, Sen-mau; |
期刊 | 臺灣醫學 |
出版日期 | 20160100 |
卷期 | 20:1 2016.01[民105.01] |
頁次 | 頁1-7 |
分類號 | 415.922 |
語文 | chi |
關鍵詞 | 中風中心; tPA血栓溶解治療; 低劑量tPA; 急性缺血性腦中風; 急性腦梗塞; 地區醫院; 臺灣中風登錄; Stroke center; tPA thrombolytic therapy; Low dose tPA; Acute ischemic stroke; Acute cerebral infarction; Local community hospital; Taiwan stroke registry; |
中文摘要 | 台灣胞漿素原活化劑(tissue plasminogen activator, tPA)血栓溶解治療急性腦梗塞的施打率偏低,尤 其是地區醫院。本研究探討地區醫院成立中風中心,以「低劑量tPA」(0.6毫克/公斤體重,最大劑量60 毫克)治療急性腦梗塞中風的效果及安全性。2013年3月,由醫學中心在地區醫院協助成立中風中心,至 2015年2月的兩年間以經靜脈低劑量tPA治療急性腦梗塞患者。於134位急性腦梗塞患者,33例為中風 發生後3小時内到院,全部可在25分鐘内完成腦部斷層掃描檢查、13例接受低劑量tPA治療 (13/134=9.7%)、11例到院至施打tPA時間<60分鐘(11/13=84.6%),無症狀性腦出血發生,與「台灣中風 登錄」相當,8例中風24小時美國國家衛生院腦中風量表(NIHSS)進步>4分(8/13=61.5%),8例中風3個 月之改良式Rankin量表(mRS)S1(8/13=61.5%),也與美國NINDS結果相當。總結:由醫學中心支援,在 地區醫院成立中風中心是可行而省時的;且經靜脈低劑量tPA的效果與標準劑量相當,也可能較安全。 |
英文摘要 | The utilization of intravenous tPA-thrombolytic therapy in acute ischemic stroke is low in Taiwan, especially in local community hospitals. This study evaluates the efficacy and safety of low dose tPA therapy (0.6mg/kg����max 60mg) in a stroke center at community hospital. We set up a stroke center in March 2013, and treated patients with acute ischemic stroke with low dose tPA within 3 hours after the onset. Thirty-three (24.6%) out of all 134 infarct patients were sent to hospital within 3 hours after stroke onset and scanned by head CT within 25 minutes. Thirteen patients (9.7%) were treated with tPA. Door to needle time could be kept within 60 minutes in 11 patients (84.6%). There was no symptomatic intracranial hemorrhage. Comparing with the nationwide statistics from Taiwan Stroke Registry, our results are comparable and even better. Eight patients (61.5%) achieved significant improvement in terms of post-tPA reduction of National Institutes of Health Stroke Scale (NIHSS) within 24hrs for more than 4 points. Eight patients (61.5%) had favorable outcome with mRS_1 after 3 months. The results were similar to those from NINDS's study (Standard dose: 0.9mg/kg,max 90mg). Therefore, low dose intravenous tPA therapy was effective and safe in the stroke center at community hospital. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。