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用于对患者进行动脉内血管再通治疗现场分诊的移动卒中治疗单元。

A Mobile Stroke Treatment Unit for Field Triage of Patients for Intraarterial Revascularization Therapy.

作者信息

Cerejo Russell, John Seby, Buletko Andrew B, Taqui Ather, Itrat Ahmed, Organek Natalie, Cho Sung-Min, Sheikhi Lila, Uchino Ken, Briggs Farren, Reimer Andrew P, Winners Stacey, Toth Gabor, Rasmussen Peter, Hussain Muhammad S

机构信息

Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.

Department of Neurology, Cleveland Clinic, Cleveland, OH.

出版信息

J Neuroimaging. 2015 Nov-Dec;25(6):940-5. doi: 10.1111/jon.12276. Epub 2015 Jul 14.

Abstract

INTRODUCTION

Favorable outcomes in intraarterial therapy (IAT) for acute ischemic stroke (AIS) are related to early vessel recanalization. The mobile stroke treatment unit (MSTU) is an on-site, prehospital, treatment team, laboratory, and CT scanner that reduces time to treatment for intravenous thrombolysis and may also shorten time to IAT.

METHODS

Using our MSTU database, we identified patients that underwent IAT for AIS. We compared the key time metrics to historical controls, which included patients that underwent IAT at our institution six months prior to implementation of the MSTU. We further divided the controls into two groups: (1) transferred to our institution for IAT and (2) directly presented to our emergency room and underwent IAT.

RESULTS

After 164 days of service, the MSTU transported 155 patients of which 5 underwent IAT. We identified 5 historical controls that were transferred to our center for IAT. Substantial reduction in times including median door to initial CT (12 minute vs. 32 minute), CT to IAT (82 minute vs. 165 minute), and door to MSTU/primary stroke center departure (37 minute vs. 106 minute) were noted among the two groups. Compared to the 6 patients who presented to our institution directly, the MSTU process times were also shorter.

CONCLUSION

Our initial experience shows that MSTU may help in early triage and shorten the time to IAT for AIS.

摘要

引言

急性缺血性卒中(AIS)动脉内治疗(IAT)的良好预后与早期血管再通有关。移动卒中治疗单元(MSTU)是一个现场的、院前的治疗团队、实验室和CT扫描仪,它减少了静脉溶栓的治疗时间,也可能缩短IAT的时间。

方法

利用我们的MSTU数据库,我们确定了接受AIS的IAT治疗的患者。我们将关键时间指标与历史对照组进行了比较,历史对照组包括在MSTU实施前六个月在我们机构接受IAT治疗的患者。我们进一步将对照组分为两组:(1)转至我们机构接受IAT治疗的患者,以及(2)直接到我们急诊室并接受IAT治疗的患者。

结果

在服务164天后,MSTU运送了155名患者,其中5名接受了IAT治疗。我们确定了5名转至我们中心接受IAT治疗的历史对照患者。两组患者的时间显著缩短,包括从入院到首次CT检查的中位时间(12分钟对32分钟)、CT检查到IAT的时间(82分钟对165分钟)以及入院到MSTU/初级卒中中心离开的时间(37分钟对106分钟)。与直接到我们机构就诊的6名患者相比,MSTU的处理时间也更短。

结论

我们的初步经验表明,MSTU可能有助于早期分诊,并缩短AIS的IAT时间。

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