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直升机紧急医疗服务转运对脑卒中患者有益吗?

Does helicopter emergency medical service transfer offer benefit to patients with stroke?

机构信息

Mayo Medical School, Mayo Clinic, Rochester, MN, USA.

出版信息

Stroke. 2012 Mar;43(3):878-80. doi: 10.1161/STROKEAHA.111.640987. Epub 2011 Dec 8.

Abstract

BACKGROUND AND PURPOSE

Helicopter transportation of patients with acute stroke who have received recombinant tissue-type plasminogen activator is commonly considered the best option. We evaluated if transportation by helicopter can reduce complications and improve clinical outcomes in patients with acute stroke.

METHODS

We conducted a review of consecutive patients with acute ischemic stroke transferred to our hospital after intravenous thrombolysis initiated at a referral center.

RESULTS

A total of 122 patient transportations were analyzed, 94 by air and 28 by ground. Time from activation of the transport system to arrival at our hospital was significantly shorter with air transportation (53 versus 68 minutes, P=0.04). Two complications were noted in the air group and no complications were noted in the ground group (P=1.0). All other outcome measures were not significantly different between groups.

CONCLUSIONS

Air transfer of patients with acute ischemic stroke treated with thrombolysis does not seem to impart any benefit to patient outcomes when compared with ground transport. Therefore, ground transport should be considered for these patients unless they are being considered for emergency endovascular rescue therapy.

摘要

背景与目的

接受重组组织型纤溶酶原激活剂溶栓治疗的急性脑卒中患者常首选直升机转院。本研究旨在评估直升机转运是否可以降低急性脑卒中患者的并发症发生率并改善其临床结局。

方法

我们对在转诊中心接受静脉溶栓治疗后转至我院的连续急性缺血性脑卒中患者进行了回顾性分析。

结果

共分析了 122 例患者的转运,其中 94 例采用直升机,28 例采用地面转运。与地面转运相比,采用直升机转运时患者自启动转运系统至到达我院的时间显著缩短[(53±68)min 比(68±68)min,P=0.04]。在直升机组中发生了 2 例并发症,而在地面组中未发生任何并发症(P=1.0)。两组患者的其他结局指标均无显著差异。

结论

与地面转运相比,接受溶栓治疗的急性缺血性脑卒中患者采用直升机转运似乎并未给患者结局带来获益。因此,除非患者拟行紧急血管内取栓治疗,否则应考虑为这些患者选择地面转运。

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