KẾT QUẢ ĐIỀU TRỊ NHỒI MÁU NÃO CẤP TRONG GIAI ĐOẠN TỪ 3 ĐẾN 4,5 GIỜ BẰNG THUỐC TIÊU HUYẾT KHỐI ALTEPLASE LIỀU THẤP

Abstract

Background: Stroke is considered the third leading cause of death after cardiovascular disease and cancer. Objectives: To evaluate the outcomes of acute ischemic stroke treatment within the time window of 3 to 4.5 hours using low-dose Alteplase thrombolytic medication. To identify prognostic factors for neurological functional recovery at the 3-month mark. Materials and Methods: Prospective, Follow-up Study without Control Group, involving 105 Acute Ischemic Stroke patients at the People's Hospital 115 from May to September 2022. Results: The average NIHSS score reduced by over 5 points 24 hours after Alteplase administration, and this difference was statistically significant with p < 0.05. However, the NIHSS score change from 1 to 24 hours post-treatment was not significantly different, only decreasing by approximately 1 point. At discharge, the NIHSS score continued to decrease by an average of nearly 0.2 points. According to the Mori classification, the non-recanalization rate (still completely occluded) in the study was 39.0%, minimal recanalization was 7.6%, moderate recanalization was 10.5%, and complete recanalization was 15.2%. The proportion of patients with good recovery and complete independence in daily activities (mRS 0-1) was 58.1%. The average level of disability (mRS 2-3), indicating partial dependency on caregivers, accounted for 31.4%. The three-month mortality rate, most occurring within the first 10 days, was 4.8% with five cases reported. Conclusion: The low-dose Alteplase thrombolytic therapy within a 3 to 4.5-hour time window for acute ischemic stroke patients needs to be extended in application and requires proper training for technology transfer.