From the Stroke Department, Gloucestershire Royal Hospital, Gloucester, UK (D.D., K.H.); Emergency Department, Southmead Hospital, Bristol, UK (J.K.); Stroke Department, Bristol Royal Infirmary, Bristol, UK (C.H., P.M., S.C.); Stroke Department, Salisbury District Hospital, Salisbury, UK (T.B., D.W.); Stroke Department, Musgrove Park Hospital, Taunton, UK (R.W.); and Emergency Department, Great Western Hospital, Swindon, UK (K.A.).
Stroke. 2015 Mar;46(3):867-9. doi: 10.1161/STROKEAHA.114.008190. Epub 2015 Jan 20.
There is limited evidence for remote stroke thrombolysis using telephone consultation and teleradiology. Results from a UK network using this treatment model are presented.
Retrospective study of consecutive patients thrombolysed in 5 hospitals, with well organized stroke services, between 2012 and 2013. Remote thrombolysis was compared with thrombolysis delivered in person for symptomatic intracerebral hemorrhage, death within 7 days, and 90-day modified Rankin scores.
Of 586 patients, 220 (37.5%) were thrombolysed remotely. The 2 groups were well matched (median age 77 years, NIHSS 12). Remote thrombolysis increased treatment time by 22 minutes. Outcomes were no different in the 2 groups (remote versus standard): symptomatic intracerebral hemorrhage (3.6% versus 4.6%), death within 7 days (6.4% versus 7.1%), modified Rankin score <2 (46.0% versus 46.1%), and modified Rankin score 6 (15% versus 17.5%) at 90 days.
Telephone advice and teleradiology, within an organized system of care, can be an effective method of delivery of intravenous thrombolysis.
利用电话咨询和远程放射学进行远程脑卒中溶栓的证据有限。本文呈现了一个英国网络采用这种治疗模式的结果。
对 2012 年至 2013 年间在 5 家具有完善脑卒中服务的医院中接受溶栓治疗的连续患者进行回顾性研究。将远程溶栓与在医院接受溶栓治疗的患者进行比较，比较指标为症状性颅内出血、7 天内死亡和 90 天改良 Rankin 评分。
在 586 例患者中，220 例（37.5%）接受了远程溶栓治疗。两组患者的情况匹配良好（中位年龄 77 岁，NIHSS 12 分）。远程溶栓治疗使治疗时间延长了 22 分钟。两组的结局没有差异（远程溶栓组与标准溶栓组）：症状性颅内出血（3.6%与 4.6%）、7 天内死亡（6.4%与 7.1%）、90 天改良 Rankin 评分<2（46.0%与 46.1%）和改良 Rankin 评分 6（15%与 17.5%）。
在有组织的护理系统中，电话咨询和远程放射学是一种有效的静脉溶栓治疗方法。
