CIC-1431 Inserm département de Neurologie, EA 481 laboratoire de neurosciences intégratives et cliniques université de Franche-Comté, UBFC, CHRU de Besançon, Besançon, France; Télémédecine 360, TLM360, Paris, France.
HESPER EA 7425, université Lyon, université Claude Bernard Lyon 1, 69008 Lyon, France; Pôle IMER, hospices civils de Lyon, 69003 Lyon, France.
Rev Neurol (Paris). 2020 May;176(5):316-324. doi: 10.1016/j.neurol.2019.11.004. Epub 2020 Mar 5.
Acute telestroke is the use of telemedicine to improve acute stroke care. It has demonstrated to be a safe and effective medical practice. Since 2011, acute telestroke has been promoted by the Ministry of Health in France, and in 2018 many regions were in the process or completion of implementing telestroke. The objective of this study was to describe acute telestroke implementation in France.
A systematic review was conducted using PubMed and ScienceDirect databases. Articles and abstracts in English and French, published between January 1st, 2000 to April 30th, 2018 were used. Studies conducted in France and that had presented an outcome evaluation of a regional acute telestroke activity were included. No meta-analysis was conducted.
A total of 24 studies (14 in French, 10 in English) were included, with 13 published articles (7 indexed on PubMed) and 11 abstracts. Among the 13 published articles, there were seven observational retrospective studies, one quasi-experimental before-after study, one experimental randomised controlled trial, and four medico-economic studies. All telestroke network models of care were drip-and-ship with hub and spoke organisation. The case-control studies did not show a difference with or without telemedicine. The territorial thrombolysis rate was measured in two regions, with an increase in Franche-Comté from 0.2% (2004) to 9.9% (2015), and a relative increase of 76% in Nord-Pas-de-Calais between 2009-2010 and 2012.
Implementation of acute telestroke in France had a positive clinical and public health impact but the evaluation remained limited and needs to be supported.
急性远程卒中是利用远程医疗来改善急性卒中的护理。它已被证明是一种安全有效的医疗实践。自 2011 年以来，法国卫生部一直在推广急性远程卒中，2018 年许多地区正在实施或完成远程卒中。本研究的目的是描述法国急性远程卒中的实施情况。
使用 PubMed 和 ScienceDirect 数据库进行系统综述。检索了 2000 年 1 月 1 日至 2018 年 4 月 30 日期间发表的英文和法文的文章和摘要。纳入了在法国进行且对区域急性远程卒中活动的结果评估进行了报道的研究。未进行荟萃分析。
共纳入 24 项研究（14 项为法文，10 项为英文），其中 13 项为已发表的文章（7 项在 PubMed 上索引）和 11 项摘要。在已发表的 13 篇文章中，有 7 项观察性回顾性研究、1 项准实验前后研究、1 项实验性随机对照试验和 4 项医疗经济研究。所有远程卒中网络护理模式均采用滴水转运和中心辐射组织。病例对照研究未显示有无远程医疗的差异。有两个地区测量了区域性溶栓率，弗朗什孔泰地区从 2004 年的 0.2%增加到 2015 年的 9.9%，诺尔-加莱地区在 2009-2010 年和 2012 年之间相对增加了 76%。
法国急性远程卒中的实施具有积极的临床和公共卫生影响，但评估仍然有限，需要得到支持。
