急性腦梗塞之血栓溶解治療可有條件放寬至 4.5 小時
發表醫師 胡朝榮 主任
週一, 01 六月 2009 23:08
至 4.5 小時但以下這些情況還是要維持 3 小時規範 1. 80 歲以上 2. 正在服用抗凝血藥物, INR 1.7 以上 3. 症狀嚴重之腦梗塞 (NIHSS 25 分以上) 4. 曾有中風病史並合併有糖尿病 (二者兼具) 其餘急性腦梗塞之血栓溶解治療可放寬至發病後 4.5 小時內
Experts Recommend Expansion of Stroke Treatment Window for Some
The treatment window for some stroke patients may be extended to within 4.5 hours of symptom onset, according to a science advisory from the American Heart Association and American Stroke Association, published online in Stroke. The groups stressed, however, that therapy within 3 hours remains ideal "because the opportunity for improvement is greater with earlier treatment."
According to the advisory, patients eligible* for therapy with recombinant tissue plasminogen activator (rtPA) who are not treated within 3 hours can be treated up to 4.5 hours — unless they:
are older than 80;
are taking oral anticoagulants with an international normalized ratio of 1.7 or lower (?);
have an NIH stroke scale score greater than 25; have a history of both stroke and diabetes.
For these groups, rtPA must be given within 3 hours.