黄斑下出血是位于视网膜光感受器细胞层和视网膜色素上皮层(retinal pigment epithelium, RPE)之间的出血,可能由年龄相关性黄斑变性(age-related macular degeneration, AMD)、视网膜大动脉瘤等疾病引起。血凝块释放的铁对感光细胞、...黄斑下出血是位于视网膜光感受器细胞层和视网膜色素上皮层(retinal pigment epithelium, RPE)之间的出血,可能由年龄相关性黄斑变性(age-related macular degeneration, AMD)、视网膜大动脉瘤等疾病引起。血凝块释放的铁对感光细胞、视网膜循环等都具有毒性作用,因此血凝块的吸收快慢是预后良好与否的关键,利用41号(41G)微针行视网膜下注射人组织纤溶酶原激活剂(tissue plasminogen activator, t-PA)联合玻璃体切除术(pars plana vitrectomy, PPV)和气体填塞术能更有效、更安全地治疗视网膜下出血,从而快速吸收血凝块以保护视功能。现报道1例利用41G微针在视网膜下注射重组人组织纤溶酶原激活剂以治疗黄斑下出血。Submacular hemorrhage is bleeding between the retinal pigment epithelium (RPE) and the photoreceptor cell layer of the retina. It can be caused by age-related macular degeneration (AMD), large aneurysms of the retina and other diseases. The iron released by blood clots has toxic effects on photoreceptor cells and retinal circulation, so the absorption rate of blood clots is the key to good prognosis. Subretinal injection of human tissue plasminogen activator was performed using 41 (41G) microneedles, the combination with pars plana vitrectomy (PPV) and gas tamponage can more effectively and safely treat subretinal bleeding, thereby rapidly absorbing the blood clot to preserve visual function. We report a case of submacular hemorrhage treated by subretinal injection of recombinant human tissue plasminogen activator using 41G microneedles.展开更多
目的:探究阿替普酶(Recombinant tissue plasminogen activator,rt-PA)静脉溶栓对急性脑梗死(Acute cerebral infarction,ACI)患者神经功能及脑出血发生情况的影响。方法:选取2019年9月至2022年9月医院收治的62例ACI患者作为研究对象,...目的:探究阿替普酶(Recombinant tissue plasminogen activator,rt-PA)静脉溶栓对急性脑梗死(Acute cerebral infarction,ACI)患者神经功能及脑出血发生情况的影响。方法:选取2019年9月至2022年9月医院收治的62例ACI患者作为研究对象,根据溶栓方案不同分为对照组和观察组,各31例。对照组采用静脉滴注注射用尿激酶溶栓,观察组采用静脉给药注射用重组组织纤溶酶原激活剂-阿替普酶溶栓。分析比较两组治疗前、治疗后2 w时的神经功能[美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分];神经损伤标志物水平[神经元特异性烯醇化酶(Neuron specific enolase,NSE)、中枢性神经特异性蛋白(Central nervous system specific proteinβ,S100β)];溶栓后24 h血管再通情况;溶栓后48 h内脑出血发生情况。结果:治疗2 w时,两组NIHSS评分均较治疗前明显降低,且观察组NIHSS评分明显低于对照组(P<0.05);两组血清NSE、S100β水平均较治疗前明显降低,且观察组血清NSE、S100β均明显低于对照组(P<0.05)。溶栓后24 h观察组血管再通率明显高于对照组(P<0.05)。溶栓后48 h内观察组脑出血发生率明显低于对照组(P<0.05)。结论:rt-PA静脉溶栓治疗ACI可改善患者神经功能及神经损伤标志物水平,促使血管再通,减少脑出血的发生。展开更多
文摘黄斑下出血是位于视网膜光感受器细胞层和视网膜色素上皮层(retinal pigment epithelium, RPE)之间的出血,可能由年龄相关性黄斑变性(age-related macular degeneration, AMD)、视网膜大动脉瘤等疾病引起。血凝块释放的铁对感光细胞、视网膜循环等都具有毒性作用,因此血凝块的吸收快慢是预后良好与否的关键,利用41号(41G)微针行视网膜下注射人组织纤溶酶原激活剂(tissue plasminogen activator, t-PA)联合玻璃体切除术(pars plana vitrectomy, PPV)和气体填塞术能更有效、更安全地治疗视网膜下出血,从而快速吸收血凝块以保护视功能。现报道1例利用41G微针在视网膜下注射重组人组织纤溶酶原激活剂以治疗黄斑下出血。Submacular hemorrhage is bleeding between the retinal pigment epithelium (RPE) and the photoreceptor cell layer of the retina. It can be caused by age-related macular degeneration (AMD), large aneurysms of the retina and other diseases. The iron released by blood clots has toxic effects on photoreceptor cells and retinal circulation, so the absorption rate of blood clots is the key to good prognosis. Subretinal injection of human tissue plasminogen activator was performed using 41 (41G) microneedles, the combination with pars plana vitrectomy (PPV) and gas tamponage can more effectively and safely treat subretinal bleeding, thereby rapidly absorbing the blood clot to preserve visual function. We report a case of submacular hemorrhage treated by subretinal injection of recombinant human tissue plasminogen activator using 41G microneedles.
文摘目的:探究阿替普酶(Recombinant tissue plasminogen activator,rt-PA)静脉溶栓对急性脑梗死(Acute cerebral infarction,ACI)患者神经功能及脑出血发生情况的影响。方法:选取2019年9月至2022年9月医院收治的62例ACI患者作为研究对象,根据溶栓方案不同分为对照组和观察组,各31例。对照组采用静脉滴注注射用尿激酶溶栓,观察组采用静脉给药注射用重组组织纤溶酶原激活剂-阿替普酶溶栓。分析比较两组治疗前、治疗后2 w时的神经功能[美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分];神经损伤标志物水平[神经元特异性烯醇化酶(Neuron specific enolase,NSE)、中枢性神经特异性蛋白(Central nervous system specific proteinβ,S100β)];溶栓后24 h血管再通情况;溶栓后48 h内脑出血发生情况。结果:治疗2 w时,两组NIHSS评分均较治疗前明显降低,且观察组NIHSS评分明显低于对照组(P<0.05);两组血清NSE、S100β水平均较治疗前明显降低,且观察组血清NSE、S100β均明显低于对照组(P<0.05)。溶栓后24 h观察组血管再通率明显高于对照组(P<0.05)。溶栓后48 h内观察组脑出血发生率明显低于对照组(P<0.05)。结论:rt-PA静脉溶栓治疗ACI可改善患者神经功能及神经损伤标志物水平,促使血管再通,减少脑出血的发生。
