Institute of Cardiovascular and Medical Sciences, Academic Section of Geriatric Medicine, University of Glasgow, Glasgow, United Kingdom.
Cerebrovasc Dis. 2021;50(6):636-643. doi: 10.1159/000518934. Epub 2021 Sep 21.
The concept of stroke unit care has been discussed for over 50 years, but it is only in the last 25 years that clear evidence of its effectiveness has emerged to inform these discussions.
This review outlines the history of the concept of stroke units to improve recovery after stroke and their evaluation in clinical trials. It describes the first systematic review of stroke unit trials published in 1993, the establishment of a collaborative research group (the Stroke Unit Trialists' Collaboration), the subsequent analyses and updates of the evidence base, and the efforts to implement stroke unit care in routine settings. The final section considers some of the remaining challenges in this area of research and clinical practice. Key Messages: Good quality evidence confirms that stroke patients who are looked after in a stroke unit are more likely to survive and be independent and living at home 1 year after their stroke. The apparent benefits are independent of patient age, sex, stroke type, or initial stroke severity. The benefits are most obvious in units based in a discrete ward (stroke ward). The current challenges include integrating effective stroke units with more recent systems to deliver hyper-acute stroke interventions and implementing stroke units in lower resource regions.
卒中单元护理的理念已经讨论了 50 多年，但直到过去 25 年，才出现明确的证据来支持这些讨论。
本文回顾了卒中单元改善卒中后恢复的概念历史及其临床试验评估。本文描述了 1993 年发表的卒中单元试验的首次系统评价、协作研究小组（卒中单元试验者协作组）的建立、随后对证据基础的分析和更新，以及在常规环境中实施卒中单元护理的努力。最后一节考虑了该研究领域和临床实践中一些尚存的挑战。
高质量证据证实，在卒中单元接受治疗的卒中患者在 1 年后更有可能存活并独立，且能够居家生活。这种明显的益处与患者年龄、性别、卒中类型或初始卒中严重程度无关。在专门的病房（卒中病房）中设立的单元，其获益最明显。当前的挑战包括将有效的卒中单元与最近的系统相结合，以提供超急性期卒中干预措施，以及在资源较少的地区实施卒中单元。
