DOI: https://doi.org/10.22141/2224-0713.5.99.2018.142962

Medical care for patients with ischemic stroke in the first hours of the disease

G.V. Gosteva, O.Ye. Kovalenko

Abstract


Background. The purpose was to provide a retrospective comparative evaluation of clinical outcomes when managing patients in the most severe period of ischemic stroke (cerebral infarction) with the use of thrombolysis and standard therapy to further optimize the provision of medical care at various levels. Materials and methods. Ninety case histories of patients with ischemic stroke have been analyzed. Of the total number of patients, two main groups were formed: I — patients receiving standard treatment (comparison group); II — patients after thrombolytic therapy (alteplase). Some factors influencing the choice of therapeutic tactics have been analyzed, clinical and anamnestic comparative evaluation of treatment outcomes has been carried using the National Institutes of Health Stroke Scale in the most acute period of ischemic stroke. Results. It is proved that after thrombolytic therapy, the length of stay in the hospital is reduced due to increased recovery of lost functions, and the number of patients who need constant care is 1.5 times less than with conventional conservative treatment. Conclusions. Early hospitalization and initiation of treatment have a positive effect on the restoration of the functions of patients, both during thrombolysis and standard treatment. The analysis of the disease course, the results of treatment gives the opportunity to consider thrombolytic therapy as an effective and promising method for treating brain infarction, quality assurance of which is impossible without skilled work of different specialists in medical care.


Keywords


ischemic stroke; brain infarction; thrombolytic therapy; medical care; results of treatment

References


Зозуля І.С., Головченко Ю.І., Зозуля А.І., Оноприєнко О.П., Волосовец А.Д. Основні принципи діагностики, формування діагнозу, лікування та профілактики мозкового інсульту // Укр. мед. часопис. — 2015. — № 4(109). — 4XX.

Зозуля А.І., Слабкий Г.О. Усовершенствование системы оказания медицинской помощи населению при цереброваскулярных заболеваниях — составляющая общей реформы здравоохранения в Украине // Международный неврологический журнал. — 2013. — № 7(61). — С. 111-117.

Зозуля А.И. Пути реорганизации оказания медицинской помощи при цереброваскулярных заболеваниях // Укр. мед. часопис. — 2013. — № 4(96). — С. 132-135.

Зозуля І.С., Цимбалюк В.І., Зозуля А.І. Інсульт: стратегія і тактика надання медичної допомоги // Укр. мед. часопис. — 2012. — № 91. — С. 36-39.

Системный тромболизис при ишемическом инсульте / Домашенко М.А., Максимова М.Ю., Зозуля А.И. Основные принципы реорганизации медицинской помощи при сосудистых заболеваниях головного мозга // Неврология и нейрохирургия. Восточная Европа. — 2013. — № 2(18). — С. 11-17.

Mustanoja S., Meretoja A., Putaala J. Outcome by stroke etiology in patients receiving thrombolytic treatment:description subtype analysis // Stroke. — 2011 Jan. — 42(1). — 102-6.

Wardlaw J.M., Murray V., Berge E., del Zoppo G.J. Thrombo-lysis for acute ischemic stroke // The Cochrane database of systematic reviews. — 2014 Jul 29.

Amarenco P., Bogousslavsky J., Caplan L.R., Donnan G.A., Hennerici M.G. Classification of stroke subtypes // Cerebrovasc. Dis. — 2009. — 27. — 493-501.

Rha J.H., Saver J.L. The impact of recanalization on ischemic stroke outcome: a metaanlysis // Stroke. — 2007. — 38(3). — 967-973.

Czlonkowska A. Stroke management in Central and Eastern Europe: Experiencee for the STEPS Stroke Site // Invited speakers on the 2nd Internationale Congress of Central and Eastern European Stroke Society. — Warsaw, 2008 April 3–5.

European Stroke Organization. Guidelines for Management of Ischemic Stroke. — 2008 (ESO 2008).

National clinical guideline for stroke. Third edition. Incorporating the recommendations from initial management of acute stroke and transient ischemic attack (TIA) by the National Institute for Health and Clinical Excellence. — London: Royal College of Physicians, 2008 (NICE, 2008).




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