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For acute ischemic cerebrovascular disease in patients with thrombolytic therapy aims to rescue the ischemic penumbra. Although rt-PA within 3 hours of intravenous thrombolytic therapy is effective and safe, but it can arrive at the hospital within 3 hours of stroke in patients with thrombolytic very little; and progressing stroke patients accounted for 20-30% of ischemic stroke, when the symptoms get worse over conventional thrombolytic therapeutic time window, for 3 h at greater incidence of acute cerebral ischemia thrombolytic therapy, although a small number of patients can benefit from it, but the extension of the time window after thrombolysis, cerebral hemorrhage and reperfusion injury The risk also increases, thereby extending the therapeutic time window is the current problems to be solved. Acute ischemic stroke is a dynamic process of development, different patients is very large individual differences in different parts of the brain tissue tolerance to ischemia are not the same, so there is potential to extend the time window of possibilities. Ischemic stroke accounts for about 80% of all strokes, of which 15% to 20% of ischemic events occurred in the posterior circulation (vertebrobasilar system), although the incidence is lower than the anterior circulation occlusive disease, but the death rate and cause residual rate is extremely high, and the onset of many patients with mild symptoms, but continued progress after admission, symptoms of increased mortality rate as high as 85% -95%. innovations: Currently only acute progressive foreign posterior circulation ischemic 3 days after the onset of stroke using low-dose intravenous rt-PA thrombolytic therapy reported cases; domestic no acute progressive extension of posterior circulation ischemic stroke thrombolysis time window prospective studies and reports. Research contents: acute progressive posterior circulation ischemic stroke patients, symptoms occur 3-12 hours, the use of low-dose rt-PA (0.9mg/kg) intravenous thrombolytic therapy, neurological improvement was observed and adverse events occurs, the evaluation time window extending thrombolytic therapy of acute progressive posterior circulation ischemic stroke effect. Research Methods: Neurology September 2006 - July 2009 through MRIDWI diagnosed with posterior circulation infarction and show progress in 3-12 hours (NIHSS score increased gt; 2 points) of the CT-negative vertebral - basilar artery infarction 52 cases of patients enrolled in the present study, the group of patients I MRA was observed after vascular condition. The group of patients with cerebral infarction were given basic treatment (NS250ml buflomedil 200mg intravenous infusion, NS250ml brain protein hydrolyzate 20ml infusion). Enrolled patients were randomly divided into experimental and control groups, and the test is divided into groups according to thrombolysis Start time 3-6h ,6 - 9h ,9-12h three subgroups, given NS100ml rt-PA (0.9mg/kg) thrombolytic therapy. 1/10 within 1min bolus dose, and the remaining 1h drop end, rt-PA total dose does not exceed 90mg. Comparative test group and control group NIHSS score, Bathel index and the modified Rankin Scale score, adverse events were recorded. Research objectives: to extend the time window verify the use of low-dose intravenous rt-PA thrombolysis for acute progressive posterior circulation ischemic stroke efficacy and safety for future conduct progressing stroke thrombolytic therapy. Results: The group of 29 cases of intravenous thrombolysis effective 27 cases, efficiency was 93.2%. Thrombolysis within 3-6 h of which 12 cases, effective in 12 cases; 6 h-9 h thrombolysis nine cases, effective in 7 cases; 9h-12 h thrombolysis eight cases, effective in 6 cases. This shows that the best time to thrombolysis within 6h, but there is still some time to extend the efficacy of thrombolysis. Progress on the posterior circulation infarction using intravenous extend the time window (3-12h) low-dose rt-PA thrombolytic therapy can improve neurological function recovery and quality of life, symptomatic intracranial hemorrhage without increasing the incidence of adverse events such as , good security. Conclusions: Progress on the posterior circulation in patients with cerebral infarction, venous extended time window (3-12h) low-dose rt-PA thrombolytic therapy is safe and effective for clinically diagnosed, there is evidence to support the imaging of patients, an appropriate extension rt-PA thrombolysis time window may enable more patients to benefit, it is recommended cautious intravenous rt-PA thrombolysis.
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