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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Thrombolysis Following Heparin Reversal With Protamine Sulfate in Acute Ischemic Stroke: Case Series and Literature Review
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Thrombolysis Following Heparin Reversal With Protamine Sulfate in Acute Ischemic Stroke: Case Series and Literature Review

机译：肝素逆转后溶栓与急性缺血性卒中的protamine硫酸盐逆转：案例系列和文献综述

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Introduction: Administering intravenous IV tissue plasminogen activator (tPA) is the recommended standard of care in acute ischemic stroke (AIS), although it is not recommended to administer intravenous thrombolysis with tPA following heparin reversal with protamine sulfate in patients with AIS. Methods: We describe a case series of three patients and the most comprehensive literature review published to date in this specific subset of AIS patients undergoing thrombolysis following heparin reversal with protamine sulfate. The literature review was based on a scoping review methodology performed on four databases; PubMed, CINAHL, Web of Science, and Cochrane Library. All sources were searched from the inauguration of the database until February 2019. A total of six articles involving eight patients were identified. Results: The primary safety outcome of no symptomatic intracranial hemorrhage (sICH) was met in all eleven patients, although only seven cases had a good functional outcome at 3 months. Conclusions: In appropriately selected AIS patients, coagulopathy correction appears to be safe from an sICH standpoint and may be beneficial. However, given the potential for bias with observational databases, case reports and case series, extreme caution is warranted in applying these results to routine clinical practice.
机译：介绍：施用静脉内IV组织纤溶酶原激活剂（TPA）是急性缺血性卒中（AIS）的推荐护理标准，尽管在肝素逆转后肝素在AIS患者患者中，肝素逆转后不建议使用TPA给予静脉溶栓。方法：我们描述了三个患者的案例系列以及迄今为止在肝素逆转后进行溶栓溶解后迄今为止发布的最全面的文献综述迄今为止发布。文献综述基于四个数据库执行的范围审查方法; PubMed，Cinahl，科学网站和Cochrane图书馆。从数据库的就职州搜查了所有来源，直到2019年2月。确定了六个涉及八名患者的六篇文章。结果：在所有十肢患者中满足了无症状颅内出血（SICH）的主要安全结果，尽管只有7例患者在3个月内具有良好的功能结果。 Conclusions: In appropriately selected AIS patients, coagulopathy correction appears to be safe from an sICH standpoint and may be beneficial.但是，鉴于使用观察数据库的偏差潜力，案例报告和案例系列，在将这些结果应用于常规临床实践中，有必要极其谨慎。

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