局域卒中网络建设提高急性缺血性卒中血管内治疗的疗效

摘要

Objective To investigate the clinical outcome of regional stroke rescue network in improving endovascular treated patients with acute ischemic stroke (AIS). Methods A retrospective analysis was made upon regional AIS rescue network in Tianhe District, Guangzhou, which was established by Jinan University First Affiliated Hospital. All patients were divided into directly admitted group (Direct group), network hospital transferred group (Network group) and non-network hospital transferred group (Non-network group). The onset to arrive comprehensive stroke center (CSC) time, the onset to puncture time, the onset to recanalization time and the clinical outcome 3 months after treatment were compared. Results From October 2015 to July 2017, 93 patients who underwent endovascular therapy was enrolled. Among which, 37 patients were in Direct group; 31 patients were in Network group and 25 patients were in Non-network group. There were significant differences in the onset to arrive CSC time, the onset to puncture time and the onset to recanalization time among three groups, with much longer time in Non-network group (P<0.05), respectively. The non-disable rate (modified Rankin scale≤2) at 3 months was 60.0%, 45.16%, and 28.0%, in Direct group, Network group and Non-network group, respectively, with no difference between Direct and Network group (P=0.244), but significantly worse outcome in Non-network group than in direct group (P=0.039).Conclusion Regional stroke rescue network can shorten the treatment time and improve the outcome of patients with AIS.%目的 观察局域卒中急救网络提高急性缺血性卒中血管内治疗的临床效果.方法 回顾分析暨南大学附属第一医院牵头建立"天河局域急性缺血性卒中急救网"后的数据库,将接受血管内治疗患者分为综合卒中中心院内首诊组(院内首诊组)、网络医院转诊组和非网络医院转诊组,比较三组间发病-入院就诊时间、发病-穿刺时间、发病-首次再通时间和3个月功能预后情况.结果 2015年10月-2017年7月共93例血管内治疗患者,其中院内首诊组37例,网络医院转诊组31例,非网络医院转诊组25例.三组间发病-入院就诊时间、发病-穿刺时间、发病-首次再通时间均有显著差异,其中非网络医院转诊组各时间均明显延长(P<0.05).三组3个月非残疾(改良Rankin评分≤2)比例分别为60.00%、45.16%和28.00%,其中院内首诊组预后与网络医院转诊组比较差异无统计学意义(P=0.244),但院内首诊组明显优于非网络医院转诊组(P=0.039).结论 局域卒中急救网络建设可以缩短急性缺血性卒中患者救治时间,改善患者预后.