# 67歲病人急性右側偏癱與失語就診。最後正常時間2.5小時前。CT無出血。BP 192/106。優先處置?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=375054&lang=zh-tw  
> language: zh-TW  
> subject: NCLEX-RN  
> category: PA

## 題目

67歲病人急性右側偏癱與失語就診。最後正常時間2.5小時前。CT無出血。BP 192/106。優先處置?

## 選項

1. 以IV labetalol將BP降至 **✔ 正確答案**
2. 因偏癱輕微而暫不溶栓
3. 給aspirin 325 mg口服,1小時後再評
4. 等BP

**正確答案: 1**

## 解析

LKW 4.5小時內、無禁忌之急性缺血性中風:溶栓前須以IV labetalol/nicardipine將BP降至

## 深入解析

tPA後:24小時BP

## 臨床情境

NIHSS 18。INR 1.0、葡萄糖124、近期未手術、未用抗凝藥。

## 重要概念

- **Alteplase** — 重組組織型纖溶酶原活化劑 — 4.5h內缺血中風溶栓藥。
- **NIHSS** — NIH中風量表 — 量化中風嚴重度。
- **缺血半暗帶** — 梗塞核周圍可救之腦組織 — 再灌流可保存。

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