Department of Neurology at the University of Tennessee Health Science Center, Memphis, Tennessee.
J Stroke Cerebrovasc Dis. 2013 Oct;22(7):969-71. doi: 10.1016/j.jstrokecerebrovasdis.2011.12.010. Epub 2012 Feb 4.
The "drip and ship" approach for intravenous thrombolysis (IVT) is becoming the standard of care for patients with acute ischemic stroke (AIS) in communities without direct access to a stroke specialist. We aimed to demonstrate the safety of our "drip and ship" IVT protocol.
This was a retrospective study of patients with AIS treated with IVT between January 2003 and January 2011. Information on patients' baseline characteristics, neuroimaging, symptomatic intracerebral hemorrhage (sICH), and mortality was obtained from our stroke registry. A group of patients were treated with IVT by an emergency physician in phone consultation with a board-certified vascular neurologist (BCVN) at 1 of our 3 stroke network-affiliated hospitals (SNAHs). These patients were subsequently transferred to our Joint Commission-certified primary stroke center (CPSC) after completion of IVT ("drip and ship" protocol). The other patients were treated directly by a BCVN at the CPSC.
We studied 201 patients treated with IVT. Of them, 14% received IVT at a SNAH ("drip and ship" protocol) and 86% were treated at the CPSC. There were no significant differences between the 2 groups with regard to age, National Institutes of Health Stoke Scale score, stroke symptom onset-to-needle time, sICH, or in-hospital mortality.
Our "drip and ship" protocol for IVT is safe. The protocol was not associated with an excess of sICH or in-hospital mortality compared with patients who received IVT at the CPSC.
对于没有直接获得卒中专家治疗的社区急性缺血性卒中（AIS）患者，静脉溶栓（IVT）的“滴注和转运”方法正在成为标准的治疗方法。我们旨在证明我们的“滴注和转运”IVT 方案的安全性。
这是一项回顾性研究，研究对象为 2003 年 1 月至 2011 年 1 月期间接受 IVT 治疗的 AIS 患者。我们从卒中登记处获得了患者的基线特征、神经影像学、症状性颅内出血（sICH）和死亡率的信息。一组患者在我们的 3 家卒中网络附属医院之一（SNAH）由急诊医师进行 IVT 治疗，并通过电话咨询获得认证的血管神经科医师（BCVN）的意见（“滴注和转运”方案）。IVT 完成后，这些患者随后被转至我们的联合委员会认证的初级卒中中心（CPSC）（“滴注和转运”方案）。另一些患者则直接由 CPSC 的 BCVN 治疗。
我们研究了 201 例接受 IVT 治疗的患者。其中，14%的患者在 SNAH 接受 IVT（“滴注和转运”方案），86%的患者在 CPSC 接受治疗。这两组在年龄、国立卫生研究院卒中量表评分、卒中症状出现至溶栓时间、sICH 或住院死亡率方面没有显著差异。
我们的 IVT“滴注和转运”方案是安全的。与在 CPSC 接受 IVT 的患者相比，该方案并未导致 sICH 或住院死亡率增加。
