1、1Update on recent progress in drug treatment for acute ischemic stroke.J Neurol 2001;248;735-742问题 1:2Thrombolysis with recombinant tissue plasminogen activator for acute ischemic stroke:where do we go from here?A cumulative meat-analysis.Stroke 2003;34:1437-423Association of outcome with early stro
2、ke treatment:pooled analysis of ATLANTIS,ECASS,and NINDS rt-PA stroke trials.Lancet.2004 6;363(9411):768-74.4Guidelines for the early management of the patients with ischemic stroke.A specific statement from the stroke council of the American stroke association.Stroke 2003;34:1056-83The European str
3、oke initiative recommendations for stroke management:update 2003.Cerebrovasc Dis 2003;16:311-18567选择:具体情况,具体分析8问题 2:9问题 3:10问题 4:静脉溶栓:24h内不抗凝 (指南)动脉接触溶栓(支架):即时抗凝(指南)11问题 5:12男性,男性,29岁,岁,突发右侧肢体无突发右侧肢体无力半小时,力半小时,CT显显示左侧半球缺血;示左侧半球缺血;MRI显示左侧底显示左侧底节区有腔梗,血节区有腔梗,血管造影显示左管造影显示左MCA闭塞闭塞13IA尿激酶尿激酶50万单位后血管部分再通,行支架成型术后,即刻及术后万单位后血管部分再通,行支架成型术后,即刻及术后1年随访管腔通畅年随访管腔通畅1年后随访溶栓+支架术后14男 55 突然昏迷2h,既往:高血压、糖尿病DSA:基底动脉闭塞溶栓后,恢复可15男 25 右侧偏瘫失语3-4h,16男 55 昏迷 躁动7h,DSA:基底动脉闭塞;溶栓后CT有少量出血,留有构音障碍,下肢肌力3-4级1718个人观点供参考,欢迎讨论!