Institute of Cardiovascular and Medical Sciences, University of Glasgow, Royal Infirmary, Glasgow, UK.
Department of Neurology and Center for Stroke Research Berlin, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Lancet. 2020 Oct 31;396(10260):1433-1442. doi: 10.1016/S0140-6736(20)31363-5.
Stroke is a complex, time-sensitive, medical emergency that requires well functioning systems of care to optimise treatment and improve patient outcomes. Education and training campaigns are needed to improve both the recognition of stroke among the general public and the response of emergency medical services. Specialised stroke ambulances (mobile stroke units) have been piloted in many cities to speed up the diagnosis, triage, and emergency treatment of people with acute stroke symptoms. Hospital-based interdisciplinary stroke units remain the central feature of a modern stroke service. Many have now developed a role in the very early phase (hyperacute units) plus outreach for patients who return home (early supported discharge services). Different levels (comprehensive and primary) of stroke centre and telemedicine networks have been developed to coordinate the various service components with specialist investigations and interventions including rehabilitation. Major challenges include the harmonisation of resources for stroke across the whole patient journey (including the rapid, accurate triage of patients who require highly specialised treatment in comprehensive stroke centres) and the development of technology to improve communication across different parts of a service.
中风是一种复杂的、时间敏感的医疗急症，需要运转良好的医疗护理系统来优化治疗，改善患者预后。需要开展教育和培训活动，提高公众对中风的认识以及应急医疗服务的反应能力。许多城市已经试行专门的中风救护车（移动中风单元），以加快对急性中风症状患者的诊断、分诊和紧急治疗。以医院为基础的多学科中风病房仍然是现代中风服务的核心特征。许多中风病房现在在非常早期阶段（超急性期病房）发挥作用，并为返回家中的患者提供服务（早期支持出院服务）。已经开发出不同层次（全面和初级）的中风中心和远程医疗网络，以协调各种服务环节与专家调查和干预措施，包括康复。主要挑战包括协调整个患者就诊过程中的中风资源（包括对需要在综合中风中心接受高度专业化治疗的患者进行快速、准确的分诊），以及开发技术以改善服务不同部分之间的沟通。
