以质量求发展，以服务铸品牌

Journal of Nursing ›› 2021, Vol. 28 ›› Issue (3): 46-52.doi: 10.16460/j.issn1008-9969.2021.03.046

Previous Articles     Next Articles

Best Evidence Summary for Prevention of Hemorrhagic Transformation after Thrombolysis in Patients with Acute Ischemic Stroke

WANG Ya-ling, WANG Bing-han, ZHANG Yan, YIN Xue, JIANG Xin, XIONG Xiao-ming, LI Hua-li   

  1. Dept. of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, China
  • Received:2020-11-07 Published:2021-03-12

PDF (PC)

292

Like

Abstract: Objective To summarize the best evidence for the prevention of hemorrhagic transformation after thrombolysis in patients with acute ischemic stroke and to provide reference for nursing staff to reduce the incidence of hemorrhagic transformation after thrombolysis of stroke. Methods We searched Cochrane Library, JBI, BMJ, PubMed, UpToDate, NGC, GIN, SIGN, NZGG, NICE, RNAO, CNKI, Vip Datebase, Wanfang Datebase, CBM and AHA/ASA, ESO and Canadian Stroke Best Practices for eligible literature. Two researchers independently appraised articles, and extracted data from eligible studies. Results Seventeen articles were enrolled, including 9 guidelines, 5 systematic reviews, 3 expert consensuses/position statement. Totally 26 items of best evidence were summarized from seven aspects：risk factors, condition monitoring, blood pressure management, symptom identification, symptomatic treatment, medication management and diet management. Conclusion Evidence-based standardized prevention strategy should be adopted for the prevention of hemorrhagic transformation after thrombolysis of acute ischemic stroke. It is necessary to select evidence according to the national conditions, clinical practice and patients' wishes. When applying evidence, the best evidence should be applied to the prevention and management of haemorrhage transformation after thrombolysis of acute ischemic stroke, so as to reduce the incidence of hemorrhagic transformation, promote the continuous improvement of nursing quality, the clinical outcome of patients and the satisfaction of patients.

Key words: acute ischemic stroke, thrombolysis, hemorrhagic transformation, symptomatic intracerebral hemorrhage, evidence-based nursing

CLC Number: 

  • R473.74
[1] Wang W,Jiang B,Sun H,et al.Prevalence,Incidence,and Mortality of Stroke in China:Results from a Nationwide Population.Based Survey of 480 687 Adults[J]. Circulation,2017,135(8):759-771.DOI:10.1161/CIRCULATIONAHA.116.025250.
[2] Wang D, Liu J,Liu M,et a1.Patterns of Stroke Between Universitv Hospitals and Nonuniversity Hospitals in Mainland China:Prospective Muhicenter Hospital-based Registry Study[J]. World Neurosurg,2017,98(2):258-265. DOI:10.1016/j.wneu.2016.11.006.
[3] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018, 51(9):666-682.DOI:10.3760/cma.j.issn.1006-7876.2018.09.004.
[4] Kernan WN, Ovbiagele B, Black H R, et al.Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association[J]. Stroke,2014,45(7):2160-2236. DOI:10.1161/STR.0000000000000024.
[5] Coutts SB, Wein TH, Lindsay MP, et al.Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Guidelines, Update 2014[J]. Int J Stroke, 2014, 23(10):924-940. DOI:10.1111/ijs.12439.
[6] Minematsu K.Intravenous Rt-Pa Therapy: Current Status and Extending Therapeutic Time Window in Japan[J]. Rinsho Shinkeigaku, 2013, 53(11):1163-1165. DOI:10.5692/clinicalneurol.53.1163.
[7] Yaghi S, Willey JZ, Cucchiara B, et al.Treatment and Outcome of Hemorrhagic Transformation After Intravenous Alteplase in Acute Ischemic Stroke: A Scientific Statement for Healthcare Professionals from the American Heart Association/American Stroke Association[J]. Stroke, 2017, 48(12): e343-e361. DOI:10.1161/STR.0000000000000152.
[8] Seet RC, Rabinstein AA.Symptomatic Intracranial Hemorrhage Following Intravenous Thrombolysis for Acute Ischemic Stroke: A Critical Review of Case Definitions[J].Cerebrovasc Dis, 2012, 34(2):106-114. DOI:10.1159/000339675.
[9] Dharmasaroja PA, Dharmasaroja P, Muengtaweepongsa S.Outcomes of Thai Patients with Acute Ischemic Stroke after Intravenous Thrombolysis[J]. J Neurol Sci,2011, 300(1-2): 74-77. DOI:10.1016/j.jns.2010.09.029.
[10] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性脑梗死后出血转化诊治共识2019[J].中华神经科杂志, 2019, 52(4):252-265.DOI:10.3760/cma.j.issn.1006-7876.2018.09.004.
[11] Mehta RH, Cox M, Smith EE, et al.Race/Ethnic Differences in the Risk of Hemorrhagic Complications Among Patients with Ischemic Stroke Receiving Thrombolytic Therapy[J]. Stroke, 2014, 45(8):2263-2269. DOI:10.1161/STROKEAHA.114.005019.
[12] Hao Y, Yang D, Wang H, et al.Predictors for Symptomatic Intracranial Hemorrhage after Endovascular Treatment of Acute Ischemic Stroke[J]. Stroke, 2017, 48(5):1203-1209. DOI:10.1161/STROKEAHA.116.016368.
[13] Lansberg MG, O'Donnell MJ, Khatri P, et al. Antithrombotic and Thrombolytic Therapy for Ischemic Stroke: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-based Clinical Practice Guidelines[J]. Chest, 2012, 141(2 Suppl): e601S-e636S. DOI:10.1378/chest.11-2302.
[14] Steiner T, Al-Shahi Salman R, Beer R, et al. European Stroke Organisation (ESO) Guidelines for the Management of Spontaneous Intracerebral Hemorrhage[J]. Int J Stroke,2014, 9(7):840-855. DOI:10.1111/ijs.12309.
[15] Casaubon LK, Boulanger JM, Glasser E, et al.Canadian Stroke Best Practice Recommendations: Acute Inpatient Stroke Care Guidelines,Update 2015[J]. Int J Stroke, 2016, 11(2):239-252. DOI:10.1177/1747493015622461.
[16] Aromataris E, Fernandez R, Godfrey CM, et al.Summarizing Systematic Reviews: Methodological Development, Conduct and Reporting of an Umbrella Review Approach[J].Int J Evid Based Healthc, 2015, 13(3):132-140.DOI:10.1097/XEB.0000000000000055.
[17] Brouwers MC, Kho ME, Browman GP, et al.AGREE II: Advancing Guideline Development, Reporting and Evaluation in Healthcare[J]. Can Med Assoc J, 2010, 182(18): E839-E842. DOI:10.1503/cmaj.090449.
[18] Shea BJ, Reeves BC, Wells G, et al.AMSTAR 2:A Critical Appraisal Tool for Systematic Reviews That Include Randomised or Non-randomised Studies of Healthcare Interventions or Both[J]. BMJ, 2017(358):j4008. DOI:10.1136/bmj.j4008.
[19] The Joanna Briggs Institute. Joanna Briggs Institute Reviewers' Manual:2016edition[M].Australia:The Joanna Briggs Institute, 2016.
[20] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J].护士进修杂志,2015,30(11):964-967.
[21] 刘云访,喻姣花,李素云,等. ICU成人患者气管插管非计划性拔管预防及管理的证据总结[J]. 护理学报,2020,27(3):43-48.DOI:10.16460/j.issn1008-9969.2020.03.043.
[22] 李佳梅,陈鸿芳,刘宁,等. 脑梗死偏瘫患者良肢位管理的最佳证据总结[J]. 护理学报,2019,26(24):22-27.DOI:10.16460/j.issn1008-9969.2019.24.022.
[23] Liu L, Ding J, Leng X, et al.Guidelines for Evaluation and Management of Cerebral Collateral Circulation in Ischaemic Stroke 2017[J]. Stroke Vasc Neurol, 2018, 3(3):118-130. DOI:10.1136/svn-2017-000135.
[24] Furie KL, Jayaraman MV.2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke[J]. Stroke, 2018, 49(3):509-510. DOI:10.1161/STROKEAHA.118.020176.
[25] Tyrrell P, Swain S, Rudd A.NICE Guideline on Acute Stroke and TIA: Commentary[J]. Heart, 2009, 95(10):843-845. DOI:10.1136/hrt.2009.167684.
[26] Hemphill JC, Greenberg SM, Anderson CS, et al.Guidelines for the Management of Spontaneous Intracerebral Hemorrhage:A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association[J]. Stroke,2015,46(7):2032-2060. DOI:10.1161/STR.0000000000000069.
[27] Kernan WN, Ovbiagele B, Black HR, et al.Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association Published Correction Appears in Stroke[J]. Stroke, 2014, 45(7):2160-2236. DOI:10.1161/STR.0000000000000024.
[28] Prabhakaran S, Ruff I, Bernstein RA.Acute Stroke Intervention: A Systematic Review[J]. JAMA, 2015, 313(14):1451-1462. DOI:10.1001/jama.2015.3058.
[29] Appleton JP, Sprigg N, Bath PM.Blood Pressure Management in Acute Stroke[J]. Stroke Vasc Neurol, 2016, 1(2):72-82. DOI:10.1136/svn-2016-000020.
[30] Luo SY, Zhang M, Zeng WT, et al.Intravenous Thrombolysis for Acute Ischemic Stroke in Patients Receiving Antiplatelet Therapy: A Systematic Review and Meta-analysis of 19 Studies[J]. J Am Heart Assoc, 2016,5(5):e003242. DOI:10.1161/JAHA.116.003242.
[31] Wardlaw JM, Murray V, Berge E, et al.Thrombolysis for Acute Ischaemic Stroke(Review)[J].Cochrane Database of Systematic Reviews,2014(7):1-145.DOI:10.1002/14651858.CD000213.pub3.
[32] Whiteley WN, Slot KB, Fernandes P, et al.Risk Factors for Intracranial Hemorrhage in Acute Ischemic Stroke Patients Treated with Recombinant Tissue Plasminogen Activator: A Systematic Review and Meta-analysis of 55 Studies[J]. Stroke, 2012, 43(11):2904-2909. DOI:10.1161/STROKEAHA.112.665331.
[33] Demaerschalk BM, Kleindorfer DO, Adeoye OM, et al.Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke[J]. Stroke,2016,47(2):581-641.DOI:10.1161/STR.0000000000000086.
[34] 吴娅,刘承春,李玮,等. 5种评分系统对不同时间窗急性脑梗死静脉溶栓后出血转化风险预测差异的比较研究[J]. 第三军医大学学报,2017,39(17):1744-1749.DOI:10.16016 /j.1000-5404.201702008.
[35] Yaghi S, Boehme AK, Dibu J, et al.Treatment and Outcome of Thrombolysis-related Hemorrhage: A Multicenter Retrospective Study[J]. JAMA Neurol, 2015,72(12):1451-1457.DOI:10.1001/jamaneurol.2015.2371.
[36] Hacke W, Kaste M, Fieschi C, et al.Randomised Double-blind Placebo-controlled Trial of Thrombolytic Therapy with Intravenous Alteplase in Acute Ischaemic Stroke (ECASS II).Second European-australasian Acute Stroke Study Investigators[J]. Lancet,1998, 352(9136):1245-1251.DOI:10.1016/s0140-6736(98)08020-9.
[37] Wahlgren N, Ahmed N, Eriksson N, et al.Multivariable Analysis of Outcome Predictors and Adjustment of Main Outcome Results to Baseline Data Profile in Randomized Controlled Trials: Safe Implementation of Thrombolysis in Stroke-monitoring Study (SITS-MOST)[J]. Stroke,2008,39(12):3316-3322. DOI:10.1161/STROKEAHA.107.510768.
[38] Hao Y, Yang D, Wang H, et al.Predictors for Symptomatic Intracranial Hemorrhage after Endovascular Treatment of Acute Ischemic Stroke[J]. Stroke, 2017, 48(5):1203-1209.DOI:10.1161/STROKEAHA.11.016368.
[39] Zaidat OO, Castonguay AC, Gupta R, et al.North American Solitaire Stent Retriever Acute Stroke Registry: Post-marketing Revascularization and Clinical Outcome Results[J]. J Neurointerv Surg,2018, 10(Suppl 1):i45-i49.DOI:10.1136/neurintsurg-2013-010895.rep.
[1] LI Ruo-Yu, LIU Xin, LIN Ping, CHEN Dan, LIN Hua. Best evidence summary for medication safety management for discharged patients [J]. Journal of Nursing, 2025, 32(3): 50-55.
[2] YANG Xiao-juan, MAO Xiao-rong, WANG Jing, JIANG Hua, LI Rong, FAN Yu, WEN Qing, LI Lin-zhang, CHEN Xiao-rong. Best evidence summary for early enteral nutrition management in adults with severe burns [J]. Journal of Nursing, 2025, 32(3): 56-61.
[3] LIU Shuo-yi, XIONG Li-juan, LI Ling, WANG Yu-mei, HE Jia, LI Xin, YUAN Shi-lei, GUO Xue-qin, WANG Yang-jing, ZHANG Hui-juan. Quality evaluation and content analysis of clinical practice guidelines for prevention and management of frailty in elderly hospitalized patients [J]. Journal of Nursing, 2025, 32(2): 50-55.
[4] CHEN Jie, MENG Qing-tong, LIU Jing-jin, WU Yan-ni. Development of guideline-based exercise rehabilitation handbook for patients with chronic heart failure [J]. Journal of Nursing, 2024, 31(9): 36-41.
[5] FU Lu-lu, XIE Yi-xuan, WANG Yue, WEI Wei, ZHANG Chuan-ying, ZHU Yu. Evidence summary for auditory stimulation intervention for procedural pain in neonates [J]. Journal of Nursing, 2024, 31(9): 42-47.
[6] JI Rui-ting, LIN Dan-na, LIU Xiao-cheng, LI Ting-ting, XIE Ying-mei, HU Bing, YING Wen-juan. Best evidence for colostrum as oral immune therapy in premature infants [J]. Journal of Nursing, 2024, 31(8): 37-42.
[7] ZHOU Yi-feng, YANG Ji-ping, HU Zheng-zhong, YUAN Hao. Evidence summary for target-oriented blood glucose monitoring in patients undergoing hepatocellular carcinoma resection [J]. Journal of Nursing, 2024, 31(7): 46-50.
[8] YANG Jian-guo, HE Xi-fei, YAN Jian-jun, ZHANG Meng, YANG Chun-zi, XU Rong, WANG Yan-fang. Best evidence summary for application and management of regional citrate anticoagulation in continuous renal replacement therapy [J]. Journal of Nursing, 2024, 31(4): 48-53.
[9] QI Shui-lin, LIN Hua, DENG Rui-ying, LI Rong-jie, LI Ruo-yu, WANG Feng-ting. Best evidence summary for non-pharmacological treatment of pruritus in elderly patients [J]. Journal of Nursing, 2024, 31(3): 46-50.
[10] YANG Li-na, HUANG Rong, YAO Mei-qi, WANG Zhu-qing, XU Yi-Ting, XIE Pei-min. Risk prediction models for postpartum breastfeeding behavior interruption: a systematic review [J]. Journal of Nursing, 2024, 31(23): 59-65.
[11] ZHANG Zhuo-ya, GAO Wen-yuan, LI jing, GUAN Chun-yan, WANG Miao, MI Yuan-yuan, HUANG Hai-yan. Development of review indicators for perioperative voice rehabilitation in patients with organic vocal fold dysphonia and its obstacle factors [J]. Journal of Nursing, 2024, 31(22): 35-40.
[12] LI Jia-qi, YE Xiang-hong, ZUO Jun-tao, XU Yao, YAO Hong-lin. Qualitative research on nutritional support decision-making process for patients with end-stage disease: a Meta-synthesis [J]. Journal of Nursing, 2024, 31(2): 53-58.
[13] CAO Chun-ju, WANG Wen, HUANG Mei-ying, HAN Bing, ZENG Mei, LUO Wen-jie, ZHANG Xiao-qin, HUANG Wei-ling, LI Wen-ying, SU Yun-tao, TANG Su-juan. Best evidence summary for management of pruritus in patients with cholestasis [J]. Journal of Nursing, 2024, 31(18): 39-44.
[14] ZHANG Yu-jie, Li Xiaojin, Wu Jinyan, DENG Shi-si, GUO Zi-han, Wu Yanni. Evidence summary development process in Joanna Briggs Institute evidence-based healthcare centre: elaboration and explanation [J]. Journal of Nursing, 2024, 31(16): 39-43.
[15] DAI Mei-fen, LIANG Yu-zhen, YANG Jing, YOU Yan-yan, YANG Qing, CHANG Guang-ting, OU Xing-ying, HUANG Chuan-qiang, CHEN Zhi-xing, OU Jie-fen. Construction of nursing protocol for cancer-related fatigue in breast cancer patients undergoing chemotherapy based on evidence-based practice and theory of chinese medicine [J]. Journal of Nursing, 2024, 31(15): 34-38.
Viewed
Full text


Abstract

Cited
  Shared   
No Suggested Reading articles found!