Ochiai Hidenobu, Ohta Hajime, Kanemaru Katsuhiro, Okuyama Hironobu, Kume Shuichi, Matsuda Shuntaro, Kuroki Kazuo, Kawachi Kensuke, Takeshima Hideo
Department of Emergency and Critical Care Medicine Faculty of Medicine University of Miyazaki Miyazaki Japan.
Department of Neurosurgery Faculty of Medicine University of Miyazaki Miyazaki Japan.
Acute Med Surg. 2020 Aug 13;7(1):e551. doi: 10.1002/ams2.551. eCollection 2020 Jan-Dec.
We aimed to establish a telestroke system for general physicians in areas without a nearby stroke center and investigate its usefulness for recombinant tissue plasminogen activator (rt-PA) therapy for patients with acute cerebral infarction.
We used a hub and spoke model, in which a hub hospital provided telestroke support to the spoke hospitals in rural areas that were not nearby a stroke center. The telestroke support device enabled the sharing of images and real-time face-to-face discussion with a stroke specialist for diagnosis and treatment. We evaluated the effect of this telestroke system on shortening time to start rt-PA therapy.
One hub and three spoke hospitals were selected. From May 2017 to November 2018, seven patients (77.2 ± 6.3 years old) suspected to have acute cerebral infarction were treated at the spoke hospitals via this system, three of whom received intravenous rt-PA administration by a general physician under telestroke support. If these patients would have been sent via ground ambulance to the nearby stroke center, it would have taken approximately 48 min more to administer rt-PA.
Establishment of a telestroke support system for general physicians in areas without a nearby stroke center was useful for promptly performing rt-PA therapy.
我们旨在为附近没有卒中中心的地区的普通医生建立一个远程卒中系统，并研究其在急性脑梗死患者重组组织型纤溶酶原激活剂（rt-PA）治疗中的作用。
我们采用了一种中心-辐射模式，其中一家中心医院为附近没有卒中中心的农村地区的辐射医院提供远程卒中支持。远程卒中支持设备能够共享图像并与卒中专家进行实时面对面讨论，以进行诊断和治疗。我们评估了这个远程卒中系统对缩短开始rt-PA治疗时间的效果。
选择了一家中心医院和三家辐射医院。2017年5月至2018年11月，通过该系统在辐射医院治疗了7例疑似急性脑梗死的患者（77.2±6.3岁），其中3例在远程卒中支持下由普通医生进行了静脉rt-PA给药。如果这些患者通过地面救护车被送往附近的卒中中心，给予rt-PA治疗将多花费约48分钟。
为附近没有卒中中心的地区的普通医生建立远程卒中支持系统有助于及时进行rt-PA治疗。
