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Rev. méd. Chile ; 144(4): 434-441, abr. 2016. ilus, graf, tab
Article Dans Espagnol | LILACS | ID: lil-787114

Résumé

Background: Intravenous thrombolysis with recombinant tissue plasminogen activator (rt-PA) reduces disability in patients with ischemic stroke. However, its implementation in Chilean public general hospitals has been slow and faces some difficulties. Aim: To analyze the results of an intravenous thrombolysis protocol implementation in a public general hospital. Material and Methods: During a lapse of 28 months a standardized protocol for intravenous thrombolysis implemented in the emergency room of a public hospital, was prospectively evaluated. Fifty four patients with ischemic stroke were treated and assessed three months later as outpatients. Results: At three months of follow-up, 66.4% of patients subjected to thrombolysis had a favorable evolution, defined as having 0 to 1 points in the modified Rankin scale. Intracerebral hemorrhage rate was 11.1%, including 5.5% of symptomatic intracerebral hemorrhage. Four percent of patients had systemic bleeding complications after thrombolysis. The mortality rate was 14.8%. Conclusions: The success rates, mortality, and complications rate were comparable to the results obtained in international studies, despite of the absence of a stroke unit to manage stroke and its complications.


Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Activateurs du plasminogène/usage thérapeutique , Traitement thrombolytique/méthodes , Encéphalopathie ischémique/traitement médicamenteux , Accident vasculaire cérébral/traitement médicamenteux , Fibrinolytiques/usage thérapeutique , Facteurs temps , Indice de gravité de la maladie , Perfusions veineuses , Encéphale/imagerie diagnostique , Tomodensitométrie , Hémorragie cérébrale/étiologie , Hémorragie cérébrale/prévention et contrôle , Encéphalopathie ischémique/complications , Études prospectives , Reproductibilité des résultats , Résultat thérapeutique , Évolution de la maladie , Accident vasculaire cérébral/complications , Hôpitaux publics
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