北京地区医院急性脑卒中治疗与预防现况调查

目的调查北京地区医院使用尿激酶(UK)和(或)重组组织型纤溶酶原激活物(rt-PA)静脉溶栓治疗的实施情况,为改进缺血性脑卒中的治疗提供依据。方法本调查为横断面调查研究,采用问卷形式调查北京地区医院脑卒中治疗相关的医疗资源方面的情况。结果北京地区被调查医院的总体结果:98.1%的医院有急诊室,92.6%的医院有24 h头颅CT,50%的医院有UK和(或)rt-PA静脉溶栓规程,7.4%的医院有卒中单元。有UK和(或)rt-PA静脉溶栓规程的医院与无此溶栓规程的医院比较差异有显著性意义的方面为:头颅CT、磁共振成像、磁共振血管造影、磁共振弥散加权成像、磁共振灌注加权成像、数字减影血管造影、神经科医生、神经外科医生、神经介入放射医生、动脉溶栓、颈动脉支架、颅内血管成形术、重症监护病房、神经重症监护病房、卒中单元、卒中治疗程序图或临床路径。结论北京地区医院应对其拥有的卒中相关医疗资源进行组织化,提高医院静脉溶栓能力,推广卒中小组、卒中单元、卒中治疗程序图或临床路径等治疗模式,以改进卒中治疗和改善卒中预后。

Stroke treatment and prevention facilities survey in Beijing

Objective To investigate the situation of urokinase /recombinant tissue-type plasminogen activator(UK/rt-PA) therapy in hospitals located in Beijing area,thus providing some strategies for improving the prevention and treatment of stroke.Methods This cross-sectional investigation with a single-page survey was carried out to determine the situation medical sources related to stroke treatment in hospitals in Beijing.Results The general data about the investigated hospitals were: 98.1% of the surveyed facilities had emergency departments,and 92.6% had head CT service.Additionally,50% provided intravenous UK/rt-PA treatment,and 7.4% had stroke units.Comparisons between facilities providing UK/rt-PA and those without UK/rt-PA showed significant differences in the following aspects: head CT,MRI,MRA,DWI,PWI,and DSA;neurologist,neurosurgeon,and interventional neuroradiologist;intraarterial thrombolysis,carotid stenting,intracerebral angioplasty;ICU,NCU,stroke unit,and acute stroke care map/pathways.Conclusion Hospitals in Beijing should make the stroke-related medical sources organized,improve intravenous UK/rt-PA therapy,and advocate the applications of stroke team,stroke unit,stroke care map/pathway,which may improve stroke treatment and better stroke outcome.