Risk assessment and management of existing puncture bleeding complications in patients with intravenous thrombolysis and treatment experience in two cases
ZHOU Ting1 LIU Li2 TANG Ge1 LIU Shudong1 SHI Haiyang1 ZHAO Libo1 ZHANG Lili3 YANG Deyu1
1.Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China;
2.Department of Health Management, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China;
3.Department of Neurology, Daping Hospital of Army Military Medical University, Chongqing 400042, China
Abstract：For patients with acute cerebral infarction with easily compressible arterial puncture points, how to prevent complications of puncture point bleeding before intravenous thrombolysis is not elaborated in the current guidelines, and relevant reports are rare. This article reported the two patients with acute cerebral infarction with existing puncture sites were treated pass with intravenous thrombolysis. In case one, right radial artery puncture was performed one week before intravenous thrombolysis, and left radial artery puncture was performed two hours before thrombolysis, after intravenous thrombolysis, subcutaneous hematoma was found at both radial artery puncture sites, and false aneurysm was complicated at the right radial artery puncture site. After comprehensive treatment, such as fresh frozen plasma infusion, cryoprecipitate, elastic bandage, and compression of the radial artery, bleeding complications at the artery puncture site were controlled. In case two, right radial artery puncture was performed 26 hours before intravenous thrombolysis, and the radial artery puncture site was compressed by a compressor before intravenous thrombolysis, and no bleeding complications occurred at the puncture site. Although it is not contraindicated to perform intravenous thrombolysis within the last one week, patients should be assessed for the risk of complications from bleeding at the puncture site after receiving intravenous thrombolysis. For patients at higher risk, compression of the puncture site before thrombolysis may be considered to prevent complications of puncture site bleeding.
周婷1 刘莉2 唐戈1 刘曙东1 史海洋1 赵立波1 张莉莉3 杨德雨1. 静脉溶栓患者既有穿刺点出血并发症的风险评估与处理2例病例治疗体会[J]. 中国医药导报, 2023, 20(2): 185-188.
ZHOU Ting1 LIU Li2 TANG Ge1 LIU Shudong1 SHI Haiyang1 ZHAO Libo1 ZHANG Lili3 YANG Deyu1. Risk assessment and management of existing puncture bleeding complications in patients with intravenous thrombolysis and treatment experience in two cases. 中国医药导报, 2023, 20(2): 185-188.
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