2．必须经神经科专业医师确诊、神经影像学医师对CT、MRI影像评估后才允许推荐，凡影像已显示与体征相对应的梗死灶者不能入选。
3．符合下列条件者不能入选：溶栓前症状和体征迅速改善者；起病伴癫痫发作不能有效控制者；伴单一神经缺损症状无法评分者，如共济失调、感觉障碍等；有脑出血史者；6个月内有脑梗死及颅脑外伤史，遗留明显功能缺损者；严重心肝肾功能不全者；心肌梗死者；外科手术及分娩者；半年内出现活动性消化性溃疡者；胃肠或泌尿系出血者；已知出血倾向者；口服抗凝剂，凝血酶原时间＞15 s者；病前48小时内静脉用过肝素，部分凝血酶原时间延长者；血小板计数＜10×109/L，血糖＜2.8 mmol/L或＞22.2 mmol/L，治疗前收缩压＞180 mmHg或舒张压＞100 mmHg者。
4．行溶栓治疗需具备完善的紧急辅助治疗措施及处理颅内出血的抢救设备。
5．溶栓前应尽可能告知患者可能发生严重出血的危险及可能的疗效，签署自愿书。
参考文献
1 Thrombolytic therapy with streptokinase in acute ischemic stroke. The multicenter Acute Stroke Trial——Europe Study Group. N Engl J Med, 1996,335:145-150.
2 Overgaard K, Sperling B, Boysen G, et al. Thrombolytic therapy in acute ischemic stroke: danish pilot study. Stroke, 1993,24:1439-1446.
3 Mori E, Yoneda Y, Tabuchi M, et al. Intravenous recombinant tissue plasminogen activator in acute carotid artery territory stroke. Neurology,1992,42:976-982.
4 Levy DE, Brott TG, Haley EC Jr, et al. Factors related to intracranial hematoma formation in patients receiving tissue plasminogen activator for acute ischemic stroke. Stroke,1994,25,291-297.
5 Wardlaw JM, Warlow CP. Thrombolysis in acute ischemic stroke: dose it work? Stroke,1992,23:1826-1839.
6 von Kummer R,Hacke W. Safety and efficacy of intravenous tissue plasminogen activator and heparin in acute middle cerebral artery stroke. Stroke,1992, 23:646-652.
上一页 1 2 3 [4] 5 下一页
