Cerebral infarction is a type of acute cerebrovascular disease with a high mortality and disability rate. In recent years, intravenous thrombolysis therapy has been widely used as an effective treatment for cerebral infarction. However, intravenous thrombolysis therapy also carries certain risks. This article will provide you with a detailed introduction to intravenous thrombolysis therapy: the savior or risk of cerebral infarction?
1、 The basic principle of intravenous thrombolysis treatment
Intravenous thrombolysis treatment refers to injecting thrombolytic drugs into the vein, dissolving thrombi through drug action, thereby restoring cerebral vascular patency, improving cerebral blood flow, and reducing neurological deficits. Intravenous thrombolysis is mainly suitable for acute ischemic stroke, and for stroke patients with a short onset time, thrombolysis treatment has a better effect. The currently recognized time window for intravenous thrombolysis is within 4.5 or 6.0 hours of onset.
2、 Indications and contraindications for intravenous thrombolysis therapy
1. Indications
(1) Acute ischemic stroke: After cerebral infarction occurs, blood flow in the brain is obstructed, leading to neurological dysfunction. Intravenous thrombolysis therapy can quickly dissolve thrombi, restore blood flow, and alleviate neurological deficits.
(2) Transient ischemic attack (TIA): TIA is a warning signal for cerebral infarction, and intravenous thrombolysis treatment can prevent TIA from progressing to cerebral infarction.
2. Contraindications
(1) Patients with severe bleeding tendencies in the near future, such as gastrointestinal bleeding, nosebleeds, etc.
(2) Patients with severe hypertension whose blood pressure cannot be controlled below 180/110mmHg.
(3) Patients with severe heart, lung, liver, and kidney dysfunction.
(4) Patients with hemorrhagic cerebrovascular disease.
(5) Allergic constitution, patients who are allergic to thrombolytic drugs.
3、 The efficacy and risks of intravenous thrombolysis therapy
1. Effect
Intravenous thrombolysis therapy has significant effects on patients with acute ischemic stroke, which can quickly restore cerebral blood flow, reduce neurological deficits, and improve quality of life. Research has found that intravenous thrombolysis treatment can reduce the mortality rate of stroke patients by 10% -30% and the disability rate by 20% -30%.
2. Risk
(1) Bleeding risk: The most serious risk of intravenous thrombolysis treatment is bleeding, including cerebral hemorrhage, gastrointestinal bleeding, skin bleeding, etc. Severe bleeding may lead to the patient's death.
(2) Allergic reactions: Some patients are allergic to thrombolytic drugs, which may lead to allergic reactions such as rash, difficulty breathing, etc.
(3) Risk of recurrent infarction: Although intravenous thrombolysis can dissolve thrombi, some patients still have the risk of recurrent infarction after thrombolysis.
(4) Vascular rupture: A very small number of patients may experience vascular rupture during thrombolytic therapy, leading to serious consequences.
4、 How to evaluate the effectiveness and risks of intravenous thrombolysis treatment?
Before undergoing intravenous thrombolysis treatment, doctors will conduct a comprehensive evaluation based on factors such as the patient's age, condition, and medical history. Common assessment tools include the National Institutes of Health Stroke Scale (NIHSS) and the Basel Acute Stroke Scale (BAS). Doctors will weigh the effectiveness and risks of treatment based on the evaluation results, and develop appropriate treatment plans for patients.
5、 How to reduce the risk of intravenous thrombolysis treatment?
1. Strictly control the indications and contraindications, and exclude patients with severe bleeding tendency, allergic constitution, etc. who are not suitable for thrombolytic therapy.
2. Control the patient's underlying diseases such as blood pressure and blood sugar to ensure stable condition.
3. Closely monitor the patient's vital signs and take appropriate measures in a timely manner if any abnormal conditions are found.
4. Strengthen nursing during thrombolytic therapy, such as observing skin and mucosal bleeding, monitoring coagulation function, etc.
5. Develop individualized treatment plans based on the specific situation of the patient, and select thrombolytic drugs and dosages reasonably.
In summary, intravenous thrombolysis is an effective treatment for acute ischemic stroke, but it also carries certain risks. Patients and their families should strengthen their understanding of cerebral infarction. Once the condition is detected, they should seek medical attention promptly and receive thrombolytic therapy under the guidance of a doctor. At the same time, medical institutions should continuously improve their thrombolytic therapy technology to provide better treatment services for patients. In practical operation, doctors will weigh the treatment effect and risk according to the specific situation of the patient, ensuring the safety and efficacy of the patient.