Thurman R Jason, Jauch Edward C, Panagos Peter D, Reynolds Matthew R, Mocco J
Department of Emergency Medicine, VUMC Stroke Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Emerg Med Pract. 2012 Jul;14(7):1-26; quiz 26-7.
Stroke is the leading cause of long-term disability in the United States and is the fourth leading cause of death, affecting nearly 800,000 patients each year. The physical, emotional, and financial toll stroke inflicts on patients and their families cannot be overstated. At the forefront of acute stroke care, emergency clinicians are positioned to have a major impact on the quality of care that stroke patients receive. This issue outlines and reviews the literature on 4 evolving strategies reflecting developing advancements in the care of acute ischemic stroke and their potential to impact patients in the emergency department setting: (1) the expanding window for intravenous rt-PA, (2) the use of multimodal computed tomographic scanning in emergent diagnostic imaging, (3) endovascular therapies for stroke, and (4) stroke systems of care. Whether practicing in a tertiary care environment or in a remote emergency department, emergency clinicians will benefit from familiarizing themselves with these advancements and should consider how these new approaches might influence their management of patients with acute ischemic stroke.
中风是美国长期残疾的主要原因，也是第四大死因，每年影响近80万患者。中风给患者及其家庭带来的身体、情感和经济负担再怎么强调都不为过。在急性中风护理的前沿，急诊临床医生对中风患者所接受的护理质量有着重大影响。本期概述并回顾了关于4种不断发展的策略的文献，这些策略反映了急性缺血性中风护理方面的进展及其在急诊科环境中对患者产生影响的潜力：（1）静脉注射重组组织型纤溶酶原激活剂（rt-PA）的时间窗扩大；（2）在急诊诊断成像中使用多模态计算机断层扫描；（3）中风的血管内治疗；（4）中风护理系统。无论是在三级医疗环境中还是在偏远的急诊科工作，急诊临床医生都会从熟悉这些进展中受益，并应考虑这些新方法可能如何影响他们对急性缺血性中风患者的管理。
