International Medical Journal, Vol. 25., Iss. 2, 2019, P. 49−52.
EXPERIENCE OF PERFORMING SYSTEMIC THROMBOLYSIS IN STROKE OF AGED PATIENTS
Bogomolets National Medical University, Kyiv
Kyiv City Clinical Hospital N 6, Ukraine
The "golden standard" for restoration of cerebrospinal fluid flow during ischemic stroke is systemic thrombolysis, based on its understanding as a dynamic process dependent on the volume of blood supply, which, according to the patient's compliance with its criteria, is performed in accordance with the methodological recommendations of the Ministry of Health Care of Ukraine. To determine the dynamics of neurological status, to obtain neuroimaging and blood parameters in elderly patients after thrombolytic therapy, there was performed a study wherein before, during and after systemic thrombolysis, the patients were assessed using the NIHSS stroke scale and neuroimaging. Functional capabilities were ranked on the Rankin scale and the Barthel index. During the admission to hospital the patients were examined with: duplex scan of blood vessels, electrocardiogram, Echo−cardiogram, general blood test, blood glucose analysis, coagulogram, International normalized ratio, blood biochemistry. After systemic thrombolysis in patients, four of whom were severe and one with moderate neurological deficiency, there was a significant regression of focal neurological symptoms (NIHSS 0−1 points), which resulted in four of them, who had undergone a full course of treatment and were discharged on days 12−19, to a significant functional restoration of impaired neurological functions with a lack or mild impairment of vital and full self−service capacity. It is concluded that the elderly age of patients makes it necessary to choose the optimal effective protocol for the treatment of ischemic stroke against the background of atherosclerotic encephalopathy and concomitant diseases in order to avoid polypragmasia. The prevalence of stroke among the elderly persons and the aging of population of developed countries necessitates the use of thrombolytic therapy, since this reduces post−neonatal neurological deficits, increases functional recovery and, thereby, improves the life quality in these patients.
Key words: thrombolytic therapy, aged patients, stroke.