Masjuan Vallejo J
Neurologia. 2009 Jun;24(5):285-7.
Intravenous fibrinolysis in the first 3 hours from the onset of the symptoms and admission to a Stroke Unit (SU) are fundamental cornerstones of the acute ischemic stroke treatment. Intravenous fibrinolysis in Spain has been performed by the neurologists since the beginning of the century within the safety registries. The number of patients treated and accredited centers have progressively increased in recent years.
The SITS-MOST registry showed its efficacy and safety in the usual clinical practice. Spain contributed 11.9% of the patients and we now know that our results are comparable to those of the rest of the world. Although the percentage of patients still treated compared to the total of stroke patients is low, this can be expected to increase significantly with the increase of the therapeutic window and as some of the current and so controversial contraindications disappear.
Fibrinolysis has served to dynamize the Care regarding Stroke in Spain through the creation of the Regional Health Care Plans and the SU. The SU is the best treatment of stroke since they improve the morbidity-mortality with a favorable cost/efficacy balance, reducing the complications and dependence. Most of the strokes (including transient ischemic attacks and cerebral hemorrhages) benefit from them. The SU is the basis from which the number of fibrinolyses can be increased, where general cares can be applied and where new therapeutic measures such as Neuro-Interventionism, Tele-Medicine or the development of new drugs can be implemented. The publication of the National Strategy in Stroke by the Health Care Ministry is a unique opportunity to improve neurological care of stroke. No one more than the neurologists know how to treat stroke and up to now, we are the only specialists who have demonstrated that we know how to apply intravenous fibrinolysis.
症状发作后3小时内进行静脉溶栓并入住卒中单元（SU）是急性缺血性卒中治疗的基本基石。自本世纪初以来，西班牙的神经科医生就在安全登记系统内开展静脉溶栓治疗。近年来，接受治疗的患者数量和经认可的中心数量都在逐步增加。
SITS - MOST登记系统显示了其在常规临床实践中的有效性和安全性。西班牙贡献了11.9%的患者，现在我们知道我们的结果与世界其他地区相当。尽管与卒中患者总数相比，仍接受治疗的患者比例较低，但随着治疗窗口的扩大以及一些目前颇具争议的禁忌症的消失，这一比例有望显著提高。
溶栓治疗通过制定区域医疗保健计划和设立卒中单元，推动了西班牙的卒中治疗工作。卒中单元是治疗卒中的最佳方式，因为它们能改善发病率和死亡率，成本效益平衡良好，减少并发症和依赖性。大多数卒中（包括短暂性脑缺血发作和脑出血）都能从中受益。卒中单元是增加溶栓治疗数量的基础，在此可以实施一般护理，也可以开展神经介入、远程医疗或新药研发等新的治疗措施。卫生部发布国家卒中战略是改善卒中神经护理的独特契机。没有人比神经科医生更了解如何治疗卒中了，到目前为止，我们是唯一证明自己知道如何应用静脉溶栓治疗的专科医生。
