Dergiler / Bakırköy Tıp Dergisi / 2018 / Cilt: 14 - Sayı: 1

Akut İskemik İnmede İntravenöz Trombolitik Tedavi Deneyimlerimiz

Our experiences of intravenous thrombolytic treatment in acute ischemic stroke

Murat ÇABALAR,Nilay TAŞDEMİR,Hacı Ali ERDOĞAN,VİLDAN AYŞE YAYLA,Sultan ÇAĞIRICI

Sayfa
71–75
DOI
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Özet

Amaç: İnme merkezimizde akut iskemik inme tanısı ile iv - rtPA tedavisi uyguladığımız hastaların verilerini retrospektif olarak incelemekti. Gereç ve Yöntem: Çalışmaya 2012-2016 tarihleri arasında akut iskemik inme tanısı ile iv - rtPA uygulanan 92 hasta alındı. Hastaların demografik ve klinik özellikleri, hastaneye geliş-çıkış, çıkış 1. ve 3. ay NIHSS ve mRS değerleri, semptom - kapı, kapı - iğne, semptom - iğne zamanları, ASPECT skorları ve komplikasyon varlığı kaydedildi. Anlamlılık p 0.05). İntrakranial hemoraji 22 (%23.9) hastada değişik derecelerde izlenirken 20 (%21.7) hasta eksitus olduğu görüldü. Sonuç: Akut iskemik inme ile ilk 3 saatte hastaneye başvuran hastalarda iv - rtPA etkinliği kanıtlanmış bir tedavi seçeneğidir. İşlemin deneyim kazanmış multidisipliner inme ekibi tarafından uygulanması bu tedavinin başarı şansını artırabilir.

Abstract

Objective: Our aim was to evaluate the data of the patients who had acute ischemic stroke and to whom we had administered iv r-tPA in our stroke unit. Materials and Methods: We included 92 patients who had received iv r-tPA after acute ischemic stroke between 2012 and 2016. Demographic and clinical features of the patients, NIHSS and mRS values at the begining and at the end of hospitalization period and at 1st and 3rd month-follow-up, symptom-to-door, door-to-needle, symptom-to-needle times, ASPECT scores and the existance of complications were recorded. A value of p≤0.05 was considered significant. Results: Ninety-two patients (42 females and 50 males), ranging in age from 33 to 88 years (mean age±SD: 64.98±11.92 years), were evaluated. Mean ASPECT score was 9.62±0.76. The difference regarding the decrease in NIHSS scores recorded at the symptom onset and at the end of hospitalization was significant (p 0.05). Intracranial hemorrhage was observed in 22 patients (23.9%) and exitus was recorded in 20 patients (21.7%). Conclusion: Intravenous r-tPA administration to patients who were admitted to hospital in the first 3 hours after stroke onset has been proven to be beneficial. Multidisiplinary approach with experienced staff may lead to an increase in the success of this treatment.