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  • 韩宁,沈雷,黎佳思,沈红健,毕晓莹,刘建民,邓本强.急性缺血性脑卒中救治流程对院内缺血性脑卒中的救治作用[J].第二军医大学学报,2018,39(3):269-272    [点击复制]
  • HAN Ning,SHEN Lei,LI Jia-si,SHEN Hong-jian,BI Xiao-ying,LIU Jian-min,DENG Ben-qiang.Effect of rescue process of acute ischemic stroke on treating in-hospital ischemic stroke[J].Acad J Sec Mil Med Univ,2018,39(3):269-272   [点击复制]
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急性缺血性脑卒中救治流程对院内缺血性脑卒中的救治作用
韩宁1,沈雷1,黎佳思2,沈红健1,毕晓莹2,刘建民1,邓本强1*
0
(1. 海军军医大学(第二军医大学)长海医院脑血管病中心, 上海 200433;
2. 海军军医大学(第二军医大学)长海医院神经内科, 上海 200433
*通信作者)
摘要:
目的 分析海军军医大学(第二军医大学)长海医院院内急性缺血性脑卒中超急性期救治情况,探讨脑血管病中心的成立对院内缺血性脑卒中(IHIS)救治成效的影响。方法 回顾性纳入2013年9月至2017年5月海军军医大学(第二军医大学)长海医院急性救治的33例IHIS患者,对照组为765例于长海医院就诊的社区发病的急性期缺血性脑卒中患者,所有患者均在发病时间窗内接受静脉溶栓及动脉取栓。记录并分析IHIS患者从发病到呼叫会诊的时间(OCT)、得到急性救治IHIS患者例数及其占同期入院患者例次的比例、我院IHIS和社区缺血性脑卒中患者入院到溶栓治疗(进针)的时间(DNT)。同时分析我院IHIS发病涉及的科室和主要病种。结果 建立应急流程后,自2013年9月至2017年5月,我院超急性期缺血性脑卒中患者溶栓、取栓例数逐年增加,OCT逐年缩短。我院IHIS患者2013年9月至2017年5月中位DNT为39.0(39.0,45.0)min,与对照组的38.0(30.0,45.5)min相比差异无统计学意义(Z=1.872,P=0.061)。IHIS发病患者以心内科和心胸外科最多,分别为11例(33.3%)和6例(18.2%)。心房颤动是IHIS发病主要的相关疾病。结论 超急性期救治流程建立后,IHIS溶栓、取栓患者例数增加;心内科和心胸外科术后IHIS发病最多见。
关键词:  缺血性脑卒中  院内  社区  溶栓  血栓切除术
DOI:10.16781/j.0258-879x.2018.03.0269
投稿时间:2017-11-07修订日期:2018-03-05
基金项目:
Effect of rescue process of acute ischemic stroke on treating in-hospital ischemic stroke
HAN Ning1,SHEN Lei1,LI Jia-si2,SHEN Hong-jian1,BI Xiao-ying2,LIU Jian-min1,DENG Ben-qiang1*
(1. Stroke Center, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China;
2. Department of Neurology, Changhai Hospital, Navy Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To analyze the treatment of acute ischemic stroke in the hyperacute stage in Changhai Hospital of Navy Medical University (Second Military Medical University), and to explore the effect of the establishment of Stroke Center on the treatment of in-hospital ischemic stroke (IHIS). Methods A total of 33 IHIS patients were retrospectively enrolled; they received acute treatment in Changhai Hospital of Navy Medical University (Second Military Medical University) from September 2013 to May 2017 (after the establishment of Stroke Center), and 765 patients with acute ischemic stroke attacked in community-based clinics and treated in Changhai Hospital served as controls. All patients received intravenous thrombolysis and arterial thrombectomy within the time window of onset. The onset to call time, the number of patients receiving acute treatment and the ratio of them to hospitalized patients in the same term, and the time from onset to onset (door to needle time, DNT) of IHIS and community ischemic stroke patients were recorded and analyzed. At the same time, the departments and main diseases related to IHIS in our hospital were analyzed. Results After the establishment of the emergency process, the number of thrombolysis and thrombectomy treatment in hyperacute IHIS patients was increased annually, and the onset to call time was shortened annually. The median DNT of patients with IHIS in our hospital from September 2013 to May 2017 was 39.0 (39.0, 45.0) min, and there was no significant difference compared with the control group (38.0[30.0, 45.5] min; Z=1.872, P=0.061). IHIS patients were most common in the Depatment of Cardiology and Department of Thoracic Surgery, with 11 cases (33.3%) and 6 cases (18.2%), respectively. Atrial fibrillation was the main ralated disease of IHIS. Conclusion After the establishment of the treatment process in the hyperacute stage, the number of thrombolysis and thrombectomy treatment in IHIS patients is increased; IHIS most occurrs in the Depatment of Cardiology and Department of Thoracic Surgery.
Key words:  ischemic stroke  in-hospital  community  thrombolysis  thrombectomy