Chan Yu-Feng, Kwiatkowski Thomas G, Rella Joseph G, Rennie William P, Kwon Robert K, Silverman Robert A
University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07101, USA.
J Emerg Med. 2005 Nov;29(4):405-8. doi: 10.1016/j.jemermed.2005.05.002.
Nationally, only 2-3% of patients with acute ischemic stroke (AIS) currently receive tissue plasminogen activator (TPA). To better understand the reasons, we investigated the practice patterns, level of familiarity and acceptance of TPA for AIS among emergency physicians in New York City (NYC). Fifty-seven 911-receiving hospital emergency department directors were surveyed regarding TPA use. Of those responding, 37% had never used TPA to treat AIS. Lack of neurological support was reported by 33%. Departments with formal protocols were more likely to use TPA for AIS. In conclusion, there is considerable variation in the practice, knowledge, and attitudes regarding the use of TPA for AIS in NYC emergency departments. Improved educational efforts and institutional support may be necessary to ensure the appropriate use of TPA by emergency physicians.
在全国范围内，目前只有2%至3%的急性缺血性中风（AIS）患者接受组织纤溶酶原激活剂（TPA）治疗。为了更好地了解原因，我们调查了纽约市（NYC）急诊医生对AIS使用TPA的实践模式、熟悉程度和接受程度。对57名接收911急救电话的医院急诊科主任进行了关于TPA使用情况的调查。在做出回应的人中，37%从未使用TPA治疗AIS。33%的人表示缺乏神经科支持。有正式方案的科室更有可能将TPA用于AIS治疗。总之，纽约市急诊科在使用TPA治疗AIS的实践、知识和态度方面存在很大差异。可能需要加强教育力度和机构支持，以确保急诊医生正确使用TPA。
