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成都医学院第一附属医院在新冠疫情期间的脑卒中护理。

Stroke Care in the First Affiliated Hospital of Chengdu Medical College during the COVID-19 Outbreak.

机构信息

Department of Neurology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.

Department of Neurology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China,

出版信息

Eur Neurol. 2020;83(6):630-635. doi: 10.1159/000513097. Epub 2020 Dec 18.

DOI:10.1159/000513097
PMID:33341815
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7801999/
Abstract

Coronavirus disease-2019 (COVID-19) has become a pandemic disease globally. The First Affiliated Hospital of Chengdu Medical College has adopted telestroke to make stroke care accessible in remote areas. During the period January 2020 to March 2020, there was no COVID-19 case reported in our stroke center. A significant reduction of stroke admission was observed between the ischemic stroke group (235 vs. 588 cases) and the intracerebral hemorrhage group (136 vs. 150 cases) when compared with the same period last year (p < 0.001). The mean door-to-needle time (DNT) and door-to-puncture time (DPT) was 62 and 124 min, respectively. Compared to the same period last year, a significant change was observed in DNT (62 ± 12 vs. 47 ± 8 min, p = 0.019) but not in DPT (124 ± 58 vs. 135 ± 23 min, p = 0.682). A total of 46 telestroke consultations were received from network hospitals. Telestroke management in the central hospital was performed on 17 patients. Of them, 3 (17.6%) patients had brain hernia and died in hospital and 8 (47.1%) patients were able to ambulation at discharge and had a modified Rankin Scale of 0-2 at 3 months. The COVID-19 pandemic impacted stroke care significantly in our hospital, including prehospital and in-hospital settings, resulting in a significant drop in acute ischemic stroke admissions and a delay in DNT. The construction of a telestroke network enabled us to extend health-care resources and make stroke care accessible in remote areas. Stroke education and public awareness should be reinforced during the COVID-19 pandemic.

摘要

新型冠状病毒病(COVID-19)已在全球范围内成为一种大流行疾病。成都医学院第一附属医院采用远程卒中的方式,使偏远地区的卒中患者能够获得治疗。2020 年 1 月至 3 月期间,我院卒中中心未报告 COVID-19 病例。与去年同期相比,缺血性卒中组(235 例与 588 例)和脑出血组(136 例与 150 例)的卒中入院人数显著减少(p<0.001)。门到针时间(DNT)和门到穿剌时间(DPT)的平均值分别为 62 分钟和 124 分钟。与去年同期相比,DNT 显著缩短(62±12 分钟与 47±8 分钟,p=0.019),但 DPT 无显著变化(124±58 分钟与 135±23 分钟,p=0.682)。我院共接收来自网络医院的 46 次远程卒中咨询。对其中 17 名患者实施了远程卒中中心管理。其中 3 例(17.6%)患者发生脑疝,院内死亡;8 例(47.1%)患者出院时可步行,3 个月时改良 Rankin 量表评分为 0-2 分。COVID-19 大流行对我院的卒中治疗产生了显著影响,包括院前和院内治疗,导致急性缺血性卒中入院人数显著减少,DNT 延迟。远程卒中网络的建设使我们能够扩展医疗资源,使偏远地区的卒中患者也能获得治疗。在 COVID-19 大流行期间,应加强卒中教育和公众意识。