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Thrombolysis is a special method of therapy aimed at destruction and urgent evacuation from the organism of special structures - thrombus. Persons with hypertension, representatives of the older generation and other categories of persons often suffer from increasing the tone of vessels, this phenomenon is hand in hand with another: blood thickening and changes in its composition. As a result - the thrombosis begins. The thrombus is dangerous for life and health, as they can block large blood structures and provoke a secondary heart attack, stroke, gangrene, death. So that this did not happen and is assigned to such a procedure as thrombolysis. What should be known about him?

Indications for the event

In nature this method Therapies are defined as a drug impact on a generalized or local organism, using special medicines that improve the composition of the blood and its properties. In general, the main indication for thrombolesis is a state at which the hypertonus of vascular structures is observed, as well as blood thickening. In this situation, the risk of formation of thromboms is great because it is necessary to prevent the development hazardous consequences. Private cases are as follows:

• A sharply current heart muscle infarction (in particular myocardium). In this case, it is necessary to prevent blood clots and the likely death of the patient from
• Stenosis or occlusion of peripheral blood structures with the development of acute ischemia of the lower either upper limbs. In this case, the risk of gangrenous lesion is great.
• Arteries embolism (including pulmonary artery).
• The thrombolysis is shown at stroke. This is especially prescribed by thrombolesis with ischemic stroke. In hemorrhagic form, the specified procedure is contraindicated, since the risk of provoking the formation of large hematoma in brain structures.
• Thrombophlebitis.

In general, the list of readings is not exhaustive. It is necessary to solve the question of the need for a place when the patient has already been delivered to a specialized hospital.

List of contraindications

When the thrombolytic therapy can not be carried out? There are a number of contraindications of thrombolysis:

• Hypertension in the phase of decompensation at the running stages. Blood thinning can lead to the formation of an extensive hemorrhagic stroke. This is deadly.
• Postoperative period. In this situation, we are talking about the possible strengthening of postoperative bleeding from the Russian Academy of Sciences, since the drugs appointed to eliminate blood closures entail a decrease in blood lungs and a number of platelets.
• The presence of diseases of the hematological profile in the history of provoking intensive internal and external bleeding.
• Old years (after 70 years). Because the brittleness of the veins and arteries increases.
• Sugar diabetes at any stage.
• The period of gestation (tooling the fetus) and lactation. Early postpartum period.
• Neoplastic processes in the body (any localization).
• A history of retinopathy (pathological vascularization mesh shell eyes).
• Open and closed brain injuries during the first 14 days from the date of receipt.
• Ulcerative lesions of the stomach and intestines.
• The presence of a pronounced immune response to drugs for the event (allergy).
• Pancreatitis renal failure, hepatitis, liver cirrhosis and other degenerative diseases gastrointestinal tract and excretory system.

Contraindications in most cases are relative. That is, after eliminating the root cause, which caused the impossibility of treatment, you can resort to thrombolesis. At the same time, the admissibility and feasibility of therapy is solved at the discretion of a specialist.

Complications and consequences

Any treatment, the more so serious, is a risk. There is always the possibility of the formation of the following complications:

• Increased body temperature to subfebrile marks and higher (approximately 37 to 38 degrees). Hyperthermia is considered a relatively normal physiological phenomenon.
• The beginning of internal and external bleeding.
• Failure cardiac (in acute phase).
• Hemorrhagic defeat of cerebral structures (.
• Immune response to the introduced drugs (allergies).
• Arrhythmia is a violation of the rhythm of the heart.
• Lowering blood pressure.

The frequency of occurrence of the described consequences does not exceed 10-12%. Most often, patients note the drop of blood pressure, violation of blood coagulation rate, allergies. Stroces and, especially, the lethal exodus is extremely rare and, often, in elderly patients. It is important to carry out therapy in a hospital and only under the control of the doctor.

Medicinal products

Preparations for thrombolysis are diverse. Among the most effective drugs can be called the following:

• Alplaza. It is prescribed for blood dilution, but only as an auxiliary measure, since the use of a pharmaceutical agent is required together with heparin, which creates certain difficulties in the therapy.
• Streptokinase. A classic preparation with a powerful thrombolytic effect. However, blood becomes an overly liquid, and the permeability of capillaries increases. Gematomes are often formed. Streptocinase is hazardous drug With mass side Effects.
• Ansrereza. Considered medicinal last generation. It's expensive. The effect is comparable with the action of altensiplase, but the preliminary use of the heparin is not required.
• Urokinase. Also is a modern drug. Gives good survival rates (on average, 15% more than analogues). It is expensive and requires preliminary treatment with heparin.

All these are enzymatic drugs based on natural components. Other medicines are distinguished:

• Synthetic combined means. Plasminogen's urocainase and others.
• Medications selective action. PRUUROKINASA, ACTILIZE, RETEBLAZ, etc.

We are talking about a variety of preparations for thrombolysis. To take them on their own is categorically prohibited, since the risk of developing severe side effects is great.

Types of thrombolytic therapy

Classify thrombolysis can be classified in several grounds. Depending on the massiveness of the effect, it is distinguished:

• Selective thrombolysis. The drug in this case is entered directly into the damaged artery to destroy the blood clock. It is considered the most preferred treatment method in most cases.
• Non-selective impact. It is performed by intravenous infusion of drugs.

Another base is the type of drugs applied against thrombosis. Accordingly, you can talk about:

• Thrombolysis is generalized, when drugs have the highest possible range of pharmacological impact.
• Selective form when the dosage tools of the sample action are used.

All drugs pick up the doctor based on the severity of the process and its character.

Technique for holding

The drug, as already mentioned, is introduced intravenously or directly to the affected artery by means of a minimally invasive intervention. In any case, the high professionalism of the specialist is required.

About the benefits of treatment

Thrombolytic therapy positively affects the work of the heart, improving the work of the left ventricle, prevents the development of arrhythmias (in rare cases, the opposite effect is possible). The degree of vascularization of affected surrounding tissues increases (it is especially important for ischemic stroke). However, in each specific case, you need to evaluate all the risks and the overall feasibility of treatment.

Efficiency mark

Evaluation of the effectiveness of thrombolysis implies a contrasting MRI to identify the degree of effectiveness of therapy.

Accordingly, in medical practice they are talking about the following degrees of efficiency:

Receive effective one and a half hours from the moment of the addition of contrast. So the result will be the most informative.

What is it, thrombolysis? We are talking about a special method of therapy for the dilution of blood and the destruction of blood clots. It is possible to conduct such an event only in the hospital under the patient control of medical personnel. Otherwise, it will not cost without complications. Self-treatment is categorically unacceptable.

- Methodology, which is used with myocardial infarction (im). It in 30-60% of cases allows you to save the patient's life. This method of therapy is not always used.

There are certain indications and contraindications to the use of thrombolysis (similar name of thrombolytic therapy).

What is thrombolytic therapy

Relative contraindications

A number of cases permits the use of thrombolytic drugs, but makes a complicated thromboisis procedure.

Specialists of the European Community allocate 7 major factors, in the presence of which treatment should be carried out especially carefully:

• State of pregnancy.
• Laser vision correction in previous 3 months or any other laser intervention in the retinal structure of the eye.
• Ischemic states of the brain, which were noticed in the last six months.
• Conducting a vessel puncture, which was in a squeezed position.
• Resuscitation after the occurrence of problems with the heart or light in the last 3 months.
• The use of anticoagulants in the form of tablets in a recent period.
• Hypertension of arterial type with an increase in systolic pressure more than 180 mm.

With these states, you should carefully relate to the estimated benefits and possible risk. The benefits must significantly exceed the risk. Only in this case, experts can start performing thrombolytic therapy.

Conduct thrombolysis

Thrombolysis is preferably started for 30 minutes from the date of receipt of the hospital. The beginning of the disease should have to take a length of no more than 12 hours ago. Often.

Optimally, if the therapy began no later than after 3 hours. Thrombolytic therapy can be carried out after 12, and after 24 hours from the moment of development. In this case, it will lead to a decrease in the severity of the symptoms of the disease and will speed up the recovery process.

Basically, streptokinase (SC) is used for therapy. It is introduced intravenously with a dropper for half an hour or an hour. It is necessary to use about 1,500,000 units of the drug.

At the very beginning of the disease, the patient himself can use aspirin. This substance will launch the process must be checked from 300 to 500 mg of the drug.

In the same period, it is advisable to use heparin. However, the patient himself can no longer use this drug: the medication is introduced by specialists with subcutaneous injections.

Alistrelase and Alplazia are also injected. The first drug is introduced quickly, for 15 minutes. Alplaza is entered gradually, in 2 hours. At first, the dose is 15 mg and is introduced immediately. Then 0.75 mg is injected for half an hour, another 1-1.5 hours - 0.5 mg.

Heparin as a drug for therapy is not necessary. The best medication for thrombolysis is a plasminogen tissue activator.

Possible complications

The most serious complication arising against the background of thrombolysis is intracranial hemorrhages. They can lead to.

If this complication decorates, it is necessary to conduct urgent therapy in the same manner as if the stroke did not arise due to thrombosis. At the same time, it is necessary to lower hell to the indicators less than 180 mm mercury pillars.

It is also likely to develop arrhythmias and hemorrhagic bleeding in abdominal cavity and in the area of \u200b\u200bthe urogenital system.

Forecasts

In the best medical centers Using the most modern thrombolytic drugs, patient survival reaches 93-95%. However, in others medical institutions This indicator is below: about 75%, sometimes 85%.

Exact predictions depend on the condition of the patient at the time of the start of therapy. The earlier it was started, the greater the chance of successful recovery.

Gallest therapeutic effect Noticeable if thrombolesis began within 30 minutes from the date of delivery to the hospital (and no later than 3 hours from the beginning of the development of the disease).

According to different sources, the statistical data is reported on the survival of patients:

• at the beginning of therapy during the first 6 hours, mortality decreases by 25%;
• if the TLT (thrombolytic therapy) has begun between 6 to 12 hours from the moment of the beginning of the disease, the probability of death is reduced by 10%.

The effectiveness of therapy and the level of favorable forecast also affects the type of preparations used. The most modern medicines increase the effectiveness of the TLT up to several times.

For example, the use of the last generation of thrombolytic drugs reduces mortality in the first 6 hours to 50, and not 25%, as in the case of earlier drugs.

Thrombolytic therapy is not a guarantor of the lack of further it. To reduce the risk of repetition of the disease to zero, it is necessary to carry out surgical interference with the stent stage. The earlier it will be done, the better.

The main goal of the treatment of myocardial infarction is the restoration of coronary blood flow in the heart attack-bound artery. This is achieved by the use of thrombolytic agents: streptokinase, streptodecadis, urock,fabric activator plasminogen(TAP).

The use of thrombolitics is the standard for the treatment of acute myocardial infarction.

Indications for thrombolytic therapy:

A typical angiosky attack of more than 30 minutes and necessarily appropriate ECG changes:

sit down segmentSt.at least 2 leads and / or

the appearance of the "fresh" blockade of the left leg of P. Gisa.

The result of pain syndrome (myocardial infarction) is not more than 6 hours, but while maintaining angiosky pain and acute stage of myocardial infarction on ECG and up to 12 hours. The best results are achieved during the first 4 hours.

If thrombolytic therapy is carried out in the first hour, 51% of myocardium saves, for 2nd hours - 26%, during

3 hours - only 13%.

Contraindications for thrombolytic therapy:

Absolute:

Bleeding, hemorrhagic syndrome.

Hemorrhage into the brain, ischemic stroke (the abandonment of up to 3 months).

Allergy to thrombolyticism.

Ulcery disease of the stomach and 12 p / k. In the stages of exacerbation.

Relative:

Age 75 and older.

Fresh severe injuries, operations or "abdominal" biopsy.

Not controlled hypertension Hell\u003e 180/100.

Tumor.

Pregnancy or status after delivery.

Diabetic hemorrhagic retinopathy.

Chronic or acute renal failure.

Extraction tooth no earlier than 14 days.

Long cardiovary resuscitation.

The use of thrombolitics with fine-food infarction and unstable angina It is not about, since their effectiveness is not proven under these states.

Thrombolytic preparations.

Before administration streptokinaseprednisolone is introduced 60 - 90 mg.

In three years, 21 systemic thrombolysis (ST) streptokinase in a dose of 1.5 million was carried out. Unfortunately, the amount of drug is not enough, but also patients with opposites for carrying out more than 70%.

Complications of thrombolytic therapy.

Allergic reactions.

Hemorrhage: intracranial and systemic.

With the introduction of streptokinase, the risk of 1% of them, with Tap(plasminogen tissue activator) - 1.3%.

Prevention of bleeding:the right choice of indications, not to carry out intramuscular inertifications, not to carry out the catheterization of the central veins.

Treatment of bleeding: cryoprecipitate 10 units. (Fibrinogen and VIII factor). The introduction of a cryoprecipitate is shown only in the first few hours after the use of thrombolytic. Introduction of freshly frozen plasma.

Treatment with epsilonamicaproic acid (AMK) is used only when all other measures have not made the result, as this may cause refractive thrombosis. AMK is injected in a loading dose of 5 g., Then infusion 0.5 - 1 g / h to cease bleeding. Gemotransfusion with eritocitar mass with hematocrit 25% and lower.

3. Reperfusion syndrome -bleeding reduction syndrome in heart attack-bound artery. Signs: Cutting pain syndrome. ECG - Prize-Naki: Transition to a subacute stage. Disturbance of rhythm and conductivity up to ventricular fibrillation.

Treatment: The use of antiarrhythmic drugs depending on the type of arrhythmias, electrical thermal therapy. Prevention:strict monitor control, the action of antioxidants is studied, preoccamed.

Among the tromsballs conducted in our department, in addition to the reperfusion C-ma in 2 patients (1.9%), there were no other complications.

With age in the human body, certain processes occur, negatively affecting health. In particular, the vessels lose their elasticity, cholesterol plaques are formed on their walls, and the blood can become viscous.

The consequence of such processes can be an education that can partially either completely overlap the clearance of the vessel, thereby preventing normal blood circulation. It may threaten the development of complications dangerous to life. In such cases, experts can assign thrombolysis, about what it is and how it is held, talk further.

Thrombolesis - This is the procedure for administering medicines capable of dissolving the blood generated

reference. The natural process of thrombolysis is carried out by special enzymes in the blood, but they can only cope with small single tombami.

Larger blood clots can partially either completely overlap the clearance of the vessel, the result of which is a blood circulation disorder. This in turn leads to a violation of the process of supplying tissues with nutrients and oxygen.

The dysfunction of the affected brain areas, the heart muscle and other organs can lead to disability or even a fatal outcome.

Thrombolysis is used to dissolve blood cloth that prevents the blood supply to organic blood supply to the process

It is extremely important here timely treatment, therefore, in such cases, quite often resort to thrombolysis therapy, as to one of effective methods eliminating hazardous clots in the circulatory system.

This technique began to be developed in the twentieth century, and first was applied to practice for the treatment of the patient in 1995 in the United States. Finding out what thrombolesis is, we will move on to the consideration of the procedure itself and the characteristics of its appointments.

Conduct thrombolysis

Today in medicine, thrombolytic therapy is performed by 2 methods:

• systemic;
• local.

In the system method, the drug is introduced into a vein in the elbow bending

System method It is carried out in those situations when there is no accurate information about the location of the thrombus.

The drug is administered intravenously, distributed throughout the circle of blood circulation and dissolves the clock anywhere.

The method is technically simple in performance, however, it requires the use of increased medication dosage, which creates an additional load on the blood system.

Reference. The disadvantages of such a method include an increased risk of bleeding.

Local technique is more difficult because medicine It is introduced as close to the localization area of \u200b\u200bthe blood clot.

The supply of the substance occurs through the catheter, and the contrast agent is additionally introduced into the vessel. In parallel, transvuluminal catheter angiography is carried out.

With local thrombolesis, complications are less likely

The doctor controls the course of the procedure using X-ray equipment.

Reference. The plus method is the low probability of bleeding and the possibility of use even with serious chronic ailments.

After the procedure, over the day, the patient's well-being is controlled. The patient measures the following indicators:

• body temperature.

The effect is expressed in the restoration of blood flow and eliminate painful after 1 hour after the procedure.

Medicines for thrombolysis

Thrombolytic drugs used in medicine are continuously improved.

To date, preparations for thrombolysis are classified into 4 groups on the basis of the nature of the human body's influence:

Thrombolytic agents are divided into 4 species, each of which has its application

• natural enzymes ("Fibrinolysin", "streptokinase", "streptodecadis", "urocinz") - are used in the system method. Apply to the restoration of the fibrinolysis process. Apply not only on the clot, therefore bleeding can occur. Also observed allergic reactions. Such features limit their use;
• medications genetic engineering ("Actiliza", "Alplaza", "PRUUROKINAS") - selectively restore fibrinogen in the blood clots. Not able to provide general impact;
• advanced group of funds ("Retovelaza", "Tenecklaza", "Lanoteleplase") - are characterized by selective and long-term exposure;
• combined medicines ("Urock plasminogen") - combine several medicines.

The most studied is the second group. Despite the fact that they have the highest dissolution rate, are used carefully because Often cause various complications.

The remaining groups are distinguished by a narrow-controlled effect, and their use is considered in each particular case.

Contraindications

Contraindications for carrying thrombolysis are all those situations under which there is a threat of unexpected bleeding:

The procedure cannot be carried out in some cases.

1. - Increased arterial pressure.
2. Diabetes.
3. Allergic reaction to medicines.
4. Diabetic retinopathy.
5. Oncology.
6. Blood coagulation disorders.
7. Pregnancy period.
8. Insufficiency of the kidneys and liver.
9. Stomach ulcer.
10. Recently transferred operational interventions.
11. Reception of anticoagulants.
12. Chronic pathologies affecting the occurrence of bleeding (acute pancreatitis, aortic aneurysm, pericarditis).
13. Card-brain injuries with a period of limitations up to 2 weeks.

The age limit procedure does not have. But with this the limit age limit is established, equal to 75 years.

Complications

Thrombolysis therapy may arise some complications, among which the most common are the following:

• bleeding - intense (with a decrease in hemoglobin, platelets) or insignificant (the bleeding of the gums, in the injection site);
• increase body temperature indicators, chills;
• - reduction of blood pressure;
• skin rash - If the case is severe, but corticosteroids are prescribed.

Frequency of complications

The mysterious word thrombolysis sounds when treatment with a thromboembolism of a light artery (TEL), infarction, stroke or some other types of thrombosis are selected. But what kind of procedure is hidden behind this name? In order to understand the importance and necessity of such intervention, consider: what thrombolytic therapy is and to whom it is necessary.

What is this procedure

To understand what it is - thrombase treatment, pay attention to the components of the words. The name is decrypted as lysis thrombus.

W. healthy man Special blood enzymes are engaged in the destruction of thrombus, but under a number of diseases, protective forces are failed and artificial or artificial thrombolysis is required.

The need for lysis or thrombosis dissolution occurs in the following cases:

• the broken blood clots completely overlaps the clearance of the vessel, preventing blood supply to fabrics;
• cluster of thrombom makes it difficult to vascular blood flow.

Thrombolytic therapy is aimed at eliminating blood clots with medication. Tools that eliminate platelet aggregation are administered intravenously or inside the tombstone vessel.

Varieties thrombolesis

Depending on the place of introducing the drugs necessary for thrombizis, doctors allocate the system and local techniques. Each methods have drawbacks and advantages.

Systemic

Thrombolytic preparations are introduced to a patient in Vienna on the elbow bending.

The advantages of the method are as follows:

• general blood dilution;
• the ability to dissolve blood clots on a hard-to-reach area;
• easy manipulation (can be performed, both in hospital conditions and as first aid with sharp thrombosis).

The disadvantages include the need to introduce drugs for thrombolysis in maximum therapeutic doses. Such drug impact negatively affects general condition blood.

Local (selective)

Eliminating drug thrombosis is injected into a vessel where blood clots are located.

Pros of Introduction:

• therapeutic effect is achieved in a short time;
• there is no need to introduce large doses of medicines;
• preparations less affect the total blood coagulation;
• effective after 6 hours after the cessation of blood flow to the tissues.

Selective thrombolesis has one drawback - for intervention requires a specially trained specialist. The doctor performs the doctor, introducing a catheter under the control of the ultrasound of the device.

Also, thrombolytic treatment is divided into species by the properties of the injected medicines:

• generalized (apply drugs with wide spectrum actions);
• selective (use drugs of narrowly directional influence).

Which method will be used - selected individually. The choice of time has been influenced from the moment of thrombosis, the nature of vascular disorders and many other factors.

Indications for thrombolesis

Any pronounced blood flow disorders caused by the formation of a blood clots inside the vessel.

Carrying thrombolysis is shown in the following cases:

• Myocardial infarction (OIM). Thrombolytic therapy with myocardial infarction is carried out in order to prevent blood clots to prevent blood clots and increase blood flow. Indications for thrombolysis with myocardial infarction - the first hours after the attack. If Oim occurred 6 or more hours ago, thrombolitics are not administered, but medicines are prescribed with a blood flowing effect from other groups.
• Stroke. Thrombolysis with ischemic stroke is used relatively often. But with a stroke caused by a breakdown of the vessel (hemorrhagic) procedure, the procedure does not apply due to risk to strengthen bleeding.
• Tala. Pulmonary artery thrombosis is life-threatening condition. When TEL, blood circulation in a small circle and a person dies from lack of oxygen. Indications for thrombolesis at TELE - blockage of the cloth of the pulmonary artery.
• Acute coronary syndrome (OX). Most mistakenly considers this term synonymous with heart attack cardiac muscle. But at ACS, not only myocardium suffers: rhythm and hemodynamics are broken. The cause of the coronary syndrome can be acute myocardial ischemia, an attack of unstable angina and some other heart violations. Indications for trombizisispaceaters from ACS are associated with the presence of a thrombus in coronary arteries. The heart attack is considered one of the forms of OXC.
• Acute forms of thrombophlebitis. In patients with acute thrombosis veins, thrombolesis reduces the severity of the state and improve the blood flow in the finitets.

For thrombolytic therapy, indications are associated with obstruction of veins or arteries due to the resulting blood clots. In addition to the listed states, the use of thrombolitics and with other diseases accompanied by the appearance of intravascular thromboms.

Contraindications for thrombolesis

The doctor takes into account when prescribing thrombolysis testimony and contraindications. Thrombolytic therapy is prohibited in the following cases:

• hypertensive crisis;
• recently conducted operations (risk internal bleeding at the site of surgical intervention);
• blood disease;
• age older than 70 years (vessels become fragile and the development of hemorrhages);
• the presence of benign or malignant neoplasms;
• tendency to bleeding (low blood clotting);
• diabetes;
• recently transferred to CMT (up to 2 weeks from the date of receipt);
• pregnancy;
• breast-feeding;
• ulcerative damage to the mucosa of the digestive tract;
• aneurysm of any localization;
• lack of liver or kidney function;
• individual intolerance to medicines.

Even if the contraindications listed above are not detected, then the following prohibitions exist for the procedure during acute states:

• Under Oim. Conditional contraindications for thrombolysis with myocardial infarction - the presence of atherosclerosis in the patient or from the moment of the attack passed more than 6 hours. Thrombolysis with a heart attack in these cases will be weakly effective.
• At ox. Acute coronary syndrome occurs for various reasons and contraindications to thrombolytic therapy in patients with OX is the absence of thrombosis.
• In case of stroke. Thrombolysis therapy is not always needed by patients with ONMK. If, with ischemic stroke, it is undesirable to make a procedure if a lot of time has passed since the attack, then thrombolysis in a hemorrhagic stroke is dangerous with a strengthening of intracranial hemorrhages.
• With TEL. There are no contraindications. With this pathology, there is a pronounced violation or complete cessation of pulmonary blood flow and pulmonary thromboembolism is ends with death. Conduct thrombolysis helps save lives.

But all contraindications are relative. Often, in severe cases, doctors use thrombolysis at TEL or extensive infarction without clarification of the list of prohibitions. This is due to the fact that the patient has dramatically deteriorates the vital indicators, and the introduction of thrombolitics helps to avoid fatal outcome.

Medical techniques

As mentioned earlier, there are systemic and selective ways to introduce drugs. You will get acquainted with what method is better taking into account the nature of the pathology arising and how it is conducted.

Systemic

Considered universal. Systemic thrombolysis is made by introducing drip lyseaging means through Vienna. Shown in the following cases:

• in stroke;
• with heart attack;
• with TEL.

Convenience is that assistance may be provided both in the hospital and on chipboard. Clinical recommendations When conducting therapy - control of ECG and blood coagulation.

Selective

Other name - catheter thrombolysis. At the same time, the catheter puts a doctor into a vein-affected vein or artery.

How the procedure is carried out depends on the Localization of the thromba:

• Local thrombolesis With a heart attack, they make in cardiological resuscitation by intravenous catheter. The method serves as an alternative to coronary shunting.
• Selective thrombolesis In stroke, it is rare due to the fact that it is difficult to access the brain arteries. Thrombolytic therapy with ischemic stroke using catheterization is possible only in clinics specializing in helping strokes.
• Veins thrombosis. With this pathology, lysis thrombus is considered one of the simple. The doctor enters the selected medication in Vienna limbs.

What kind of methods to use is solved individually.

The catheterization of the tombstone vessel makes it possible to more effectively eliminate the problem, and the intravenous injection of thrombolitics makes it possible to quickly assist and prevent complications.

Preparations for thrombolysis

Thrombolytic therapy with myocardial infarction, stroke or tel is carried out by various medicines. Thrombolytic agents are selected taking into account the nature of the pathology, but sometimes it is possible to use those drugs that is in the first-aid kit (the ambulance list is limited). Consider popular preparations for thrombolysis:

• Streptokinase. The classic drug for dissolving blood clots is used in myocardial or tel infarction, less often as thrombolytic therapy with ischemic stroke. During thrombosis, the drug has a powerful lysing effect, but strongly dilutes blood and increases the permeability of the vascular wall. Streptocinase is considered a thrombolytic with a large number of side effects. Most often applied with myocardial infarction and tel.
• Actilization. The mechanism of action: thrombolytics and fibrinolities. The components of the drug, enhancing the reaction with the fibrinogen, provoke the lysis of the blood clock. Despite the fact that the actilization refers to the three-generation thrombolytic drugs, the tool gives little side effects and is often used in hospitals. Actilization and other drugs of the new generation are considered to be the most sought-after means.
• Urokinase. In the classification of 4 generations is considered a convenient drug for lyseing of thrombov. When used, it gives little side effects, but it is expensive.
• Fortelizin. As the actilization, it applies to the second generation (this list of drugs is most popular for thrombosis therapy). Fortelizin is considered one of the best preparations for tromboraisis with a small amount of unwanted reactions.

The names of the drugs from the group of three generation thrombolitics is not worth listed. These modern drugs They have a minimum of contraindications are well tolerated, but they are expensive and apply only in large clinics.

Oral tools for thrombolysis no - medications apply only in injection solutions. But some patients are mistakenly confused thrombolytics and anticoagulants (warfarin), which are available in tablets and are shown for long-term reception.

Ambulance with thrombolesis for urgent states

The following clinical recommendations are indicated in the emergency system for emergency measures:

• Tala. If this state occurs, therapy is shown by thrombolysis agents, regardless of possible contraindications.
• Stroke. If there is no confidence in the character of stroke lesions, the introduction of thrombolitics is undesirable. Recommendations to the doctors and paramedics "Emergency" indicate that it is better to carry out supporting therapy to eliminate the risk of intracranial bleeding during hemorrhagic stroke.
• Oim. Thrombolysis with myocardial infarction at the prehospital stage will help in the first hours. If more than 6 hours passed since the attack, only the introduction of narcotic analgesics and the patient's delivery to the hospital is recommended.

All destinations make a doctor, and, in some cases, the paramedic. Before applying thrombolysis at the pre-hospital stage is taken into account possible benefit and harm to the patient.

What are the complications

Thrombolytics are considered "heavy" for human organism means. Consider frequently encountered complications of thrombolytic therapy:

• fever up to 38 ° and above;
• acute deficiency of the cardiac function;
• cerebral hemorrhagic hemorrhages (with ischemic stroke);
• heart rate disorders;
• drug hypotension;
• internal and exterior bleeding.

To avoid unwanted reactions, thrombolysis is carried out under the control of electrocardiography and blood coagulation.

How to evaluate efficiency

How much helps the procedure is evaluated using MRI or Dopplerography. Consider the main criteria for the effectiveness of thrombolysis:

• Zero. Funds do not affect the blood cloudy.
• First. There is a slight lysis of the tomb structure.
• Second. Bleeding appears, but the bloodstream is frequently freed.
• Third. The maximum therapeutic effect - the bloodstream is fully functional.

Need thrombolysis or not - decide individually. But if the procedure is necessary, then it should not be refused - the resorption (lysis) thrombus will improve blood circulation and prevent complications of the disease.

Video: Application of thrombolytic therapy by ambulance doctors