1997年至2004年间新西兰医生对缺血性中风治疗态度的转变：一项调查

Changing attitudes to the management of ischaemic stroke between 1997 and 2004: a survey of New Zealand physicians.

作者信息

Somerfield J, Barber P A, Anderson N E, Spriggs D, Charleston A, Bennett P

机构信息

Department of Neurology, Auckland City Hospital, Auckland, New Zealand.

出版信息

Intern Med J. 2006 May;36(5):276-80. doi: 10.1111/j.1445-5994.2006.01042.x.

DOI:10.1111/j.1445-5994.2006.01042.x

PMID:16650191

Abstract

AIM

In 1997, a survey of New Zealand physicians' opinions on the management of stroke was carried out. Since then, there have been a number of advances in stroke therapy. We have repeated the 1997 survey to assess changes in physicians' opinions on stroke management.

METHODS

A questionnaire was sent to 293 physicians responsible for patients admitted with acute stroke to hospitals throughout New Zealand. It included questions on the management of acute stroke and secondary prevention and was based on the 1997 questionnaire.

RESULTS

Responses were received from 211 physicians of whom 174 (82%) managed patients with an acute stroke. The number of respondents who thought that stroke units were efficacious has increased (57% in 1997 to 89%, P < 0.001). The use of aspirin acutely (P < 0.001) and intravenous tissue plasminogen activator (P = 0.006) has also increased. In 2004, antihypertensive therapy for secondary stroke prevention would be commenced if the blood pressure was 150/90 by 98% of respondents and 140/90 by 70% of respondents. In 2004, a statin would be commenced if the total cholesterol level was 4.0 mmol/L by 56% of respondents and 5.0 mmol/L by 91% of respondents.

CONCLUSIONS

This survey has shown important changes in the management of ischaemic stroke over the past 7 years.

摘要

目的

1997年，对新西兰医生关于中风管理的意见进行了一项调查。从那时起，中风治疗有了许多进展。我们重复了1997年的调查，以评估医生对中风管理意见的变化。

方法

向负责新西兰各地医院急性中风住院患者的293名医生发送了一份问卷。它包括关于急性中风管理和二级预防的问题，并且基于1997年的问卷。

结果

收到了211名医生的回复，其中174名（82%）负责管理急性中风患者。认为中风单元有效的受访者数量有所增加（1997年为57%，2004年为89%，P<0.001）。急性使用阿司匹林（P<0.001）和静脉注射组织纤溶酶原激活剂（P=0.006）的情况也有所增加。在2004年，如果血压为150/90，98%的受访者会开始进行中风二级预防的抗高血压治疗；如果血压为140/90，70%的受访者会开始治疗。在2004年，如果总胆固醇水平为4.0 mmol/L，56%的受访者会开始使用他汀类药物；如果总胆固醇水平为5.0 mmol/L，91%的受访者会开始使用。