Analysis Of Causes Of Non Thrombolysis In Time Window Of Patients With Acute Ischemic Stroke

Objective:By collecting the clinical data of patients with acute ischemic stroke(AIS)within the time window of intravenous thrombolytic therapy(IVT),this paper summarizes the reasons for not receiving intravenous thrombolytic therapy,analyzes the factors affecting intravenous thrombolysis,and explores countermeasures,so as to provide basis for improving the rate of intravenous thrombolysis.Methods:Summarize the clinical information of all patients who were treated in the Affiliated Hospital of Inner Mongolia University for nationalities,Tongliao hospital and Inner Mongolia forestry general hospital from June 2020 to June 2021,whose time from onset to admission was ≤ 6 hours and met the AIS diagnostic criteria in China guidelines for the diagnosis and treatment of acute ischemic stroke 2018 edition,collect IVT related data,summarize the reasons for no intravenous thrombolytic therapy within the time window,and make statistical analysis and comparison.Results:A total of 836 AIS patients whose time from onset to admission was ≤ 6hours were collected.A total of 319 patients underwent thrombolytic therapy.The proportion of patients receiving thrombolytic therapy within the time window was 38.2%,and the thrombolytic drugs were RT PA(82%)and urokinase(18%).The main reasons for non thrombolysis were pre hospital delay(22.4%),absolute contraindications(24.2%)and relative contraindications(21.7%).In addition to contraindications,the main reasons for non thrombolysis were pre hospital delay(39.6%),family members’ refusal to thrombolysis(35.8%),and patients’ advanced age(9.2%).Conclusion:Compared with developed countries,the proportion of patients receiving thrombolytic therapy still has a large gap in previous years.The DNT time has reached the international recommended 60 min,but there is still room for improvement.The main reasons for non thrombolysis in AIS patients within the time window are pre hospital delay,refusal of thrombolysis by family members,history of intracranial hemorrhage,rapid remission of patients’ symptoms,mild non disabling stroke and elderly patients.