直升机紧急医疗服务对急性缺血性脑卒中患者的影响：系统评价。
The impact of helicopter emergency medical service on acute ischemic stroke patients: A systematic review.
机构信息
The Faculty of Medicine, Bar Ilan University, Safed, Israel.
Department of Nursing, The Faculty of Health and Welfare Sciences, University of Haifa, Haifa, Israel.
出版信息
Am J Emerg Med. 2021 Apr;42:178-187. doi: 10.1016/j.ajem.2020.02.021. Epub 2020 Feb 15.
BACKGROUND
Helicopter emergency medical services (HEMS) is commonly elected transport for acute ischemic stroke (AIS) known as a time-critical illness.
AIM
To conduct a systematic review in order to explore the HEMS impact on healthcare status, process and outcome measures for AIS patients.
METHODS
A systematic search was conducted of PubMed, Medline, CINAHL, Cochrane Library and Google Scholar. The gray literature and reference lists of included articles were also searched. Thirty studies met inclusion criteria.
RESULTS
Using Donabedian's framework, two studies focused on the impact on healthcare structure, twenty-three explored the impact on process measures, and five focused on clinical outcomes. HEMS structure implications could not be assessed due to insufficient studies. HEMS showed no significant outcome benefit compared to ground emergency medical services (EMS) and the impact on process measures was ambiguous.
CONCLUSIONS
HEMS necessity varied considerably between studies. More robust studies are needed for detection of the most suitable use of HEMS in AIS.
背景
直升机紧急医疗服务（HEMS）通常被选为急性缺血性脑卒中（AIS）的转运方式，因为该病具有时间紧迫性。
目的
进行系统评价，以探讨 HEMS 对 AIS 患者的医疗保健状况、流程和结果测量的影响。
方法
对 PubMed、Medline、CINAHL、Cochrane 图书馆和 Google Scholar 进行了系统检索。还检索了纳入文章的灰色文献和参考文献列表。
结果
使用 Donabedian 的框架，有两项研究侧重于医疗保健结构的影响，有 23 项研究探讨了对流程措施的影响，有五项研究侧重于临床结果。由于研究数量不足，无法评估 HEMS 结构的影响。与地面紧急医疗服务（EMS）相比，HEMS 并没有显示出显著的结果益处，而对流程措施的影响则不明确。
结论
各研究之间 HEMS 的必要性差异很大。需要更有力的研究来发现 HEMS 在 AIS 中最适合的使用方式。
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