- 期刊
Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: The Experience of a Community Hospital
並列摘要
Background and Purpose: Tissue plasminogen activator (tPA) is a standard therapy for acute ischemic stroke (AIS) but only limited data are noted in Taiwan. The purpose of this study was to assess the safety, feasibility, and efficacy of treatment in a community hospital setting. Methods: We retrospectively reviewed the medical records of all patients who had received intravenous tPA therapy from 1998 to 2007 in our hospital. We compared thea characteristics, complications, and outcomes in our patients with those of patients in the National Institute of Neurological Disorders and Stroke (NINDS) trial. Results: A total of 43 patients were reviewed with a mean age of 63 years and a male predominane (64%). The median pretreatment National Institutes of Health Stroke Scale score was 18. In our patients, cardioembolism was the leading course of the strokes. The mean time from stroke onset to treatment was 134 minutes, and the mean door-to-computed tomography-time was 34 minutes while the mean door-to-needle time was 93 minutes. Within 36 hours symptomatic intracerebral hemorrhage occurred in two patients (4.7%). Four patients (9.3%) developed brain herniation with fatality. At follow-up, fourteen patients (33%) had a favorable outcome on the modified Rankin Scale (0-1). Patient outcome was not significantly different from that in the NINDS trial. Conclusion: Although the number of patients with AIS receiving tPA in this study was small, thrombolytic therapy can be performed safely and effectively by physicians in the community hospital setting.
被引用紀錄
延伸閱讀
- 孫穆乾（2011）。Intravenous Thrombolysis for Acute Ischemic Stroke。台灣醫學，15(5)，535-542。https://doi.org/10.6320/FJM.2011.15(5).12
- 陳右緯、鄭建興（2019）。Intravenous Thrombolysis for Acute Ischemic Stroke。台灣醫學，23(6)，722-727。https://doi.org/10.6320/FJM.201911_23(6).0004
- 連立明、陳俊榮、陳威宏、葉建宏、汪漢澄、許維志、徐榮隆、吳令治、謝欣如、邱浩彰（2000）。Preliminary Experience of Treating Acute Ischemic Stroke with Intravenous Tissue Plasminogen Activator。台灣醫學，4(4)，379-387。https://doi.org/10.6320/FJM.2000.4(4).02
- Sung, S. F., Ong, C. T., Wu, C. S., Hsu, Y. C., & Su, Y. H. (2010). Increased Use of Thrombolytic Therapy and Shortening of In-Hospital Delays Following Acute Ischemic Stroke: Experience on the Establishment of a Primary Stroke Center at a Community Hospital. Acta Neurologica Taiwanica, 19(4), 246-252. https://doi.org/10.29819/ANT.201012.0003
- 林志遠、李黔芳、張孟玲、林靜玉、詹金烈、楊文理（2016）。Improvement of Intravenous Thrombolytic Treatment in Acute Ischemic Stroke Patients with Evidence-based Medicine Approach。北市醫學雜誌，13(2)，172-180。https://doi.org/10.6200/TCMJ.2016.13.2.07