【Clinical Story】Active Thrombolytic Therapy Coma paralyzed patients recover quickly
Yesterday, the Department of Hospital of Nanyang Medical College Received an acute ischemic stroke patient, and after emergency intravenous thrombolysis treatment, the vascular recandevation was successfully achieved, and the patient's stroke symptoms basically disappeared.
At about 5:00 a.m. on February 10, 51-year-old Aunt Han felt dizzy after getting up and going to the toilet, the right limb was numb and weak, and then quickly appeared blurred, unable to speak, the right limb was paralyzed, the muscle strength was close to level 1, the family dialed our hospital 120 to send to our hospital, around 7:00 was sent to the intensive care department, the patient was in a coma, the pain in the right limb was not responsive, and the teeth were closed. Combined with imaging, medical history and physical examination, it is determined to be acute ischemic stroke, with an NIHSS score of 18 points, which is a moderate-severe stroke, and the onset time is within the time window of thrombolysis, and there is no contraindication to thrombolysis. Shi Fuxin, the doctor on duty, quickly made preparations before thrombolysis, and Director Wang Wanqun communicated with the patient's family on the benefits and risks of thrombolysis and gave thrombolytic treatment immediately after obtaining the consent of the family. The whole treatment from the beginning of thrombolysis to the end of only 1 hour, the patient's consciousness quickly turned to lucidity, language, limb function was restored, at present only dizziness, the right limb weakness symptoms, the patient's consciousness is clear, the right upper and lower limbs can move freely, fluent language.
The most important measure to restore blood flow is intravenous thrombolysis, which is also an evidence-based medically proven effective treatment for cerebral infarction.
What is intravenous thrombolytic therapy?
Thrombolytic therapy is simply to dissolve the blood clots that block the cerebral blood vessels through drugs, so that the blood vessels can return to blood, thereby saving the brain cells that have not died.
What are the effects and risks of intravenous thrombolysis?
According to domestic and foreign guidelines and research statistics:
Time is the brain, and the sooner the thrombolysis, the greater the benefit. Overall, the benefits of cerebral infarction thrombolysis are 10 times greater than the risk, with a thrombolytic remission rate of about 30-40%, symptoms improving, and a lower rate of remission of large vessel occlusion.
2. About 50-60% may have no significant re-passage after thrombolysis, and there is no significant improvement in symptoms. For every 100 patients who thrombolysis, 32 patients benefited and 3 had poor outcomes (2 worsening, 1 severely disabling or dying, but did not increase patient mortality).
Can patients with cerebral infarction be thrombolytic?
No. We have to dissolve the thrombolysis before the necrosis of the brain tissue occurs, so there is a time window, generally required within 4.5 hours, and special cases need to be considered by the doctor.
How do you know if it's a cerebral infarction?
At present, the "FAST" recipe is commonly used internationally as an early warning signal for stroke.
F (Face) can't smile on his face and the corners of his mouth are crooked
A (Arm) arm can not be lifted
The S (Speech) language does not answer fluently or is slurred
T(Time) time
Once one of the above three items (F, A, S) is found to be present, please call the emergency number (T) immediately and transfer the patient to a hospital with a condition for treatment.
Director Wang Wanqun reminded:
Intravenous thrombolysis must not be delayed in order to go to a large hospital, and should be treated in accordance with the principle of proximity to the nearest hospital with thrombolysis ability to avoid delaying the timing.
Source: Nanyang Medical College No. 2 Affiliated Hospital
