共查询到20条相似文献,搜索用时 15 毫秒
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溶栓治疗是急性缺血性卒中的主要治疗方法.组织型纤溶酶原激活剂是美国食品药品管理局唯一批准的卒中治疗药物,但由于治疗时间窗狭窄和存在出血并发症风险等原因限制了其临床应用.为了解决这个问题,大量的临床试验开始致力于动脉溶栓、机械溶栓和超声溶栓治疗的研究. 相似文献
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A. V. Alexandrov 《Journal of internal medicine》2010,267(2):209-219
Abstract. Alexandrov AV (University of Alabama Hospital, Birmingham, AL, USA). Current and future recanalization strategies for acute ischemic stroke (Review). J Intern Med 2010; 267: 209–219. In a quest for stroke treatment, reperfusion proved to be the first key to the puzzle. Systemic tissue plasminogen activator (tPA), the first and currently the only approved treatment, is also the fastest way to initiate thrombolyis for acute ischemic stroke. tPA works by induction of mostly partial recanalization since stroke patients often have large thrombus burden. Thus, early augmentation of fibrinolysis and multi‐modal approach to improve recanalization are desirable. This review focuses on the following strategies available to clinicians now or being tested in clinical trials: (a) faster initiation of tPA infusion; (b) sonothrombolysis; (c) intra‐arterial revascularization, bridging intravenous and intra‐arterial thrombolysis, mechanical thrombectomy and aspiration; and (d) novel experimental approaches. Despite these technological advances, no single strategy was yet proven to be a ‘silver bullet’ solution to reverse acute ischemic stroke. Better outcomes are expected with faster treatment leading to early, at times just partial flow improvement rather than achieving complete recanalization with lengthy procedures. Arterial re‐occlusion can occur with any of these approaches, and it remains a challenge since it leads to poor outcomes and no clinical trial data are available yet to determine safe strategies to prevent or reverse re‐occlusion. 相似文献
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Justine Sudre MD Laura Venditti MD Claire Ancelet MD Olivier Chassin MD Mariana Sarov MD Didier Smadja MD Nicolas Chausson MD François Lun MD Olga Laine MD Emmanuelle Duron MD Christiane Verny MD Laurent Spelle MD Alexandra Rouquette MD Nicolas Legris MD Christian Denier MD 《Journal of the American Geriatrics Society》2021,69(11):3167-3176
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曲东锋 《国际脑血管病杂志》2004,12(9):680-680
试验状态 :从 2 0 0 3年 10月开始 ,已经募集 3例患者。试验目的 :比较动脉内rtPA溶栓与静脉rtPA溶栓的疗效。试验设计 :多中心剂量开放随机对照试验 ,采用盲法随访。纳入标准 :大脑中动脉 (MCA)缺血性卒中发病 3h内的患者。排除标准 :卒中发病前已有残疾 ,发病时昏迷 ,神经功能缺损迅速改善 ,发病时出现癫 ,对比增强剂过敏 ,分娩期或哺乳期 ,未经控制的高血压 ,颅内出血 ,溶栓治疗的禁忌证或存在其他有可能增加患者危险的任何情况。患者处理 :患者随机分为静脉溶栓组和动脉内溶栓组 ,静脉溶栓组患者 (rtPA 0 9mg/kg ,最大剂量 90mg)… 相似文献
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动脉再通治疗可快速恢复血流并挽救缺血半暗带组织,已成为急性缺血性卒中最有效的治疗手段.许多新的血管再通方法已应用于临床.文章对该领域的研究进展进行了综述. 相似文献
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目前,在发病4.5h内进行静脉溶栓仍然是治疗急性缺血性卒中患者的最有效方法。对于不符合静脉溶栓治疗标准、静脉溶栓后症状无明显改善甚至恶化的患者,血管内介入治疗是一种安全的替代治疗方法。经动脉机械取栓装置能实现迅速和完全的血管再通,为急性缺血性卒中患者提供了更多的治疗选择。文章对近年来机械取栓装置相关的技术演变和临床试验进行了综述。 相似文献
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动脉再通治疗可快速恢复血流并挽救缺血半暗带组织,已成为急性缺血性卒中最有效的治疗手段.许多新的血管再通方法已应用于临床.文章对该领域的研究进展进行了综述. 相似文献
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大量动物实验和临床研究表明,血管内低温对缺血性卒中具有神经保护作用。文章从作用机制、临床研究、影响治疗结果的因素以及并发症的防治等方面对缺血性卒中的血管内低温治疗进行了综述。 相似文献
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Early treatment for acute ischemic stroke 总被引:5,自引:0,他引:5
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Goldstein LB 《Current atherosclerosis reports》2001,3(4):299-306
Over the past decade, there has been an explosion in data related to the treatment of patients with acute ischemic stroke.
Thrombolytic therapy with intravenous tissue plasminogen activator has revolutionized the approach to stroke treatment. Intra-arterial
administration of thrombolytic agents is also being investigated and is now being used on a compassionate basis. Medical management
can have a large impact on stroke-related outcomes, even in patients who do not receive thrombolytic therapy. 相似文献
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动脉再通治疗可快速恢复血流并挽救缺血半暗带组织,已成为急性缺血性卒中最有效的治疗手段.许多新的血管再通方法已应用于临床.文章对该领域的研究进展进行了综述. 相似文献
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静脉溶栓是治疗急性缺血性卒中的首选方法,但在大血管闭塞性卒中患者中的血管再通率较低.以血管内机械血栓切除术为代表的血管内治疗能有效使缺血性卒中患者闭塞血管再通和改善转归.文章对静脉溶栓桥接治疗的现状和发展方向进行了综述. 相似文献
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Kitagawa Y 《Internal medicine (Tokyo, Japan)》2006,45(5):225-226