中国卒中杂志 ›› 2022, Vol. 17 ›› Issue (07): 695-705.DOI: 10.3969/j.issn.1673-5765.2022.07.004
收稿日期:
2022-05-18
出版日期:
2022-07-20
发布日期:
2022-07-20
通讯作者:
朱以诚zhuych910@ 163.com
Received:
2022-05-18
Online:
2022-07-20
Published:
2022-07-20
摘要:
院内卒中患者虽然卒中发病时置身医院环境,但由于其基础病情复杂、识别困难、治疗禁忌证多等因素,存在再灌注治疗延迟和再灌注率低等情况,是导致院内卒中预后不良的重要因素。针对院内卒中再灌注治疗流程中不同环节的延误原因,加强院内卒中识别、改进溶栓绿色通道流程、重视头颅影像学中灌注成像检查等措施有利于改善院内卒中再灌注治疗的延误。我国院内卒中救治体系尚未完善,未来需结合我国国情、院内卒中的特征以及先进中心的经验,加强绿色通道诊治流程建设和改良,以改善院内卒中患者的预后。
刘子悦, 朱以诚. 院内卒中再灌注治疗研究进展[J]. 中国卒中杂志, 2022, 17(07): 695-705.
LIU Ziyue, ZHU Yicheng. Progress of Reperfusion Therapy for In-hospital Stroke[J]. Chinese Journal of Stroke, 2022, 17(07): 695-705.
[1] MONCH S,LEHM M,MAEGERLEIN C,et al. Worse endovascular mechanical recanalization results for patients with in-hospital onset acute ischemic stroke[J]. J Neurol,2018,265(11):2525-2530. [2] EMIRU T,ADIL M M,SURI M F K,et al. Thrombolytic treatment for in-hospital ischemic strokes in United States[J]. J Vasc Interv Neurol,2014,7(5):28-34. [3] BEKELIS K,MISSIOS S,COY S,et al. Comparison of outcomes of patients with inpatient or outpatient onset ischemic stroke[J]. J Neurointerv Surg,2016,8(12):1221-1225. [4] TOPIWALA K,TARASARIA K,STAFF I,et al. Identifying gaps and missed opportunities for intravenous thrombolytic treatment of inpatient stroke[J/OL]. Front Neurol,2020,11:134[2022-04-10]. https://doi.org/10.3389/fneur.2020.00134. [5] AKBIK F,XU H L,XIAN Y,et al. Trends in reperfusion therapy for in-hospital ischemic stroke in the endovascular therapy era[J]. JAMA Neurol,2020,77(12):1486-1495. [6] MORADIYA Y,LEVINE S R. Comparison of short-term outcomes of thrombolysis for in-hospital stroke and out-of-hospital stroke in United States[J]. Stroke,2013,44(7):1903-1908. [7] 徐敏,王惠琴,杨红燕,等. 院内卒中应急流程在急性脑梗死溶栓治疗中的应用[J]. 中华护理杂志,2012,47(3):204-205. [8] FAROOQ M U,REEVES M J,GARGANO J,et al. In-hospital stroke in a statewide stroke registry[J]. Cerebrovasc Dis,2008,25(1/2):12-20. [9] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志,2018,51(9):666-682. [10] POWERS W J,RABINSTEIN A A,ACKERSON T,et al. Guidelines for the early management of patients with acute ischemic stroke:2019 update to the 2018 guidelines for the early management of acute ischemic stroke:a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J/OL]. Stroke,2019,50(12):e344-e418[2022-04-10]. https://doi.org/10.1161/str.0000000000000211. [11] CAPARROS F,FERRIGNO M,DECOURCELLE A,et al. In-hospital ischaemic stroke treated with intravenous thrombolysis or mechanical thrombectomy[J]. J Neurol,2017,264(8):1804-1810. [12] CADILHAC D A,KILKENNY M F,LANNIN N A,et al. Outcomes for patients with in-hospital stroke:a multicenter study from the Australian stroke clinical registry(AuSCR)[J]. J Stroke Cerebrovasc Dis,2019,28(5):1302-1310. [13] DULLI D,SAMANIEGO E A. Inpatient and community ischemic strokes in a university hospital[J]. Neuroepidemiology,2007,28(2):86-92. [14] DEL BRUTTO V J,ARDELT A,LOGGINI A,et al. Clinical characteristics and emergent therapeutic interventions in patients evaluated through the in-hospital stroke alert protocol[J]. J Stroke Cerebrovasc Dis,2019,28(5):1362-1370. [15] SCHURMANN K,NIKOUBASHMAN O,FALKENBURGER B,et al. Risk profile and treatment options of acute ischemic in-hospital stroke[J]. J Neurol,2016,263(3):550-557. [16] CUMBLER E,WALD H,BHATT D L,et al. Quality of care and outcomes for in-hospital ischemic stroke: findings from the national get with the guidelines-stroke[J]. Stroke,2014,45(1):231-238. [17] BULWA Z,DEL BRUTTO V J,LOGGINI A,et al. Mechanical thrombectomy for patients with in-hospital ischemic stroke:a case-control study[J/OL]. J Stroke Cerebrovasc Dis,2020,29(5):104692[2022-04-10]. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104692. [18] CHUKWUDELUNZU F E,DEMAERSCHALK B M,FUGOSO L,et al. In-hospital stroke care:a six-year community-based primary stroke center experience[J]. Neurohospitalist,2021,11(4):326-332. [19] JO S,CHANG J Y,JEONG S,et al. Newly developed stroke in patients admitted to non-neurological intensive care units[J]. J Neurol,2020,267(10):2961-2970. [20] CUMBLER E,SIMPSON J. Code stroke:multicenter experience with in-hospital stroke alerts[J]. J Hosp Med,2015,10(3):179-183. [21] KAMAL H,AHMED M K,ZHA A,et al. Strokes occurring in the hospital:symptom recognition and eligibility for treatment in the intensive care units versus hospital wards[J]. Brain Circ,2020,6(3):196-199. [22] EMMETT E S,DOUIRI A,MARSHALL I J,et al. A comparison of trends in stroke care and outcomes between in-hospital and community-onset stroke - the South London stroke register[J/OL]. PLoS ONE,2019,14(2):e0212396[2022-04-10]. https://doi.org/10.1371/journal.pone.0212396. [23] MANAWADU D,CHOYI J,KALRA L. The impact of early specialist management on outcomes of patients with in-hospital stroke[J/OL]. PLoS One,2014,9(8):e104758[2022-04-10]. https://doi.org/10.1371/journal.pone.0104758. [24] KASSARDJIAN C D,WILLEMS J D,SKRABKA K,et al. In-patient code stroke a quality improvement strategy to overcome knowledge-to-action gaps in response time[J]. Stroke,2017,48(8):2176-2183. [25] CUMBLER E,MURPHY P,JONES W J,et al. Quality of care for in-hospital stroke:analysis of a statewide registry[J]. Stroke,2011,42(1):207-210. [26] CUMBLER E,ANDERSON T,NEUMANN R,et al. Stroke alert program improves recognition and evaluation time of in-hospital ischemic stroke[J]. J Stroke Cerebrovasc Dis,2010,19(6):494-496. [27] TSIVGOULIS G,KATSANOS A H,KADLECOVA P,et al. Intravenous thrombolysis for patients with in-hospital stroke onset:propensity-matched analysis from the safe implementation of treatments in stroke-east registry[J]. Eur J Neurol,2017,24(12):1493-1498. [28] SALTMAN A P,SILVER F L,FANG J,et al. Care and outcomes of patients with in-hospital stroke[J]. JAMA Neurol,2015,72(7):749-755. [29] GEORGE P,WISCO D R,GEBEL J,et al. Nurses are as specific and are earlier in calling in-hospital stroke alerts compared to physicians[J]. J Stroke Cerebrovasc Dis,2017,26(5):917-921. [30] EI HUSSEINI N,GOLDSTEIN L B. "Code Stroke":hospitalized versus emergency department patients[J]. J Stroke Cerebrovasc Dis,2013,22(4):345-348. [31] VERA R,LAGO A,FUENTES B,et al. In-hospital stroke:a multi-centre prospective registry[J]. Eur J Neurol,2011,18(1):170-176. [32] KOGE J,MATSUMOTO S,NAKAHARA I,et al. Improving treatment times for patients with in-hospital stroke using a standardized protocol[J/OL]. J Neurol Sci,2017,381:68-73[2022-04-10]. https://doi.org/10.1016/j.jns.2017.08.023. [33] GARCIA-SANTIBANEZ R,LIANG J,WALKER A,et al. Comparison of stroke codes in the emergency room and inpatient setting[J]. J Stroke Cerebrovasc Dis,2015,24(8):1948-1950. [34] YOO J,SONG D,LEE K,et al. Comparison of outcomes after reperfusion therapy between in-hospital and out-of-hospital stroke patients[J]. Cerebrovasc Dis,2015,40(1/2):28-34. [35] MATSUBARA N,HIRAMATSU R,YAGI R,et al. Other hospital-onset acute ischemic stroke due to large vessel occlusion treated by mechanical thrombectomy after inter-hospital transfer[J]. Neurol Med Chir(Tokyo),2020,60(4):209-216. [36] MATSUBARA N,HIRAMATSU R,YAGI R,et al. Characteristics and treatment results of in-hospital acute ischemic stroke due to large vessel occlusion treated by mechanical thrombectomy[J]. J Neuroendovascular Therapy,2019,13(7):281-287. [37] SANO T,KOBAYASHI K,ICHIKAWA T,et al. In-hospital ischemic stroke treated by mechanical thrombectomy[J]. J Neuroendovascular Therapy,2020,14(4):133-140. [38] RAO R R,DESAI S M,TONETTI D A,et al. Thrombectomy after in-house stroke in the transfer population[J/OL]. J Stroke Cerebrovasc Dis,2020,29(9):105049[2022-04-10]. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105049. [39] LU M Y,CHEN C H,YEH S J,et al. Comparison between in-hospital stroke and community-onset stroke treated with endovascular thrombectomy[J/OL]. PLoS ONE,2019,14(4):e0214883[2022-05-10]. https://doi.org/10.1371/journal.pone.0214883. [40] 谈毅,郑云华,聂德新,等. 院内缺血性卒中患者未溶栓原因分析[J]. 浙江临床医学,2018,20(8):1423-1425. [41] 郑静维,彭斌. 综合医院院内新发卒中的临床特征——附116例资料分析[J/OL]. 中华脑血管病杂志(电子版),2020,14(4):209-216[2022-04-10]. https://zhnxgbzz.cma-cmc.com.cn/CN/10.11817/j.issn.1673-9248.2020. 04.005. [42] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组,中华医学会神经病学分会神经血管介入协作组. 中国急性缺血性脑卒中早期血管内介入诊疗指南2018[J]. 中华神经科杂志,2018,51(9):683-691. [43] NATTERU P,MOHEBBI M R,GEORGE P,et al. Variables that best differentiate in-patient acute stroke from stroke-mimics with acute neurological deficits[J/OL]. Stroke Res Treat,2016,2016:4393127[2022-04-10]. https://doi.org/10.1155/2016/4393127. [44] SUGII N,ZABORONOK A,FUJIMORI H,et al. Stroke mimics and accuracy of referrals made by emergency department doctors in Japan for patients with suspected stroke[J]. J Stroke Cerebrovasc Dis,2019,28(4):1078-1084. [45] KOZERA-STRZELINSKA D,KARLINSKI M,RAK G,et al. Stroke and TIA mimics in patients referred to a neurological emergency department by non-ambulance physicians,ambulance physicians and paramedics[J]. Neurol Neurochir Pol,2019,53(1):83-89. [46] BUNCH M E,NUNZIATO E C,LABOVITZ D L. Barriers to the use of intravenous tissue plasminogen activator for in-hospital strokes[J]. J Stroke Cerebrovasc Dis,2012,21(8):808-811. [47] KHATRI P,KLEINDORFER D O,DEVLIN T,et al. Effect of alteplase vs aspirin on functional outcome for patients with acute ischemic stroke and minor nondisabling neurologic deficits:the PRISMS randomized clinical trial[J]. JAMA,2018,320(2):156-166. [48] NOUH A,AMIN-HANJANI S,FURIE K L,et al. Identifying best practices to improve evaluation and management of in-hospital stroke:a scientific statement from the American Heart Association[J/OL]. Stroke,2022,53(4):e165-e175[2022-04-10]. https://doi.org/10.1161/str.0000000000000402. [49] MASJUAN J,SIMAL P,FUENTES B,et al. In-hospital stroke treated with intravenous tissue plasminogen activator[J]. Stroke,2008,39(9):2614-2616. [50] CUMBLER E,ZAEMISCH R,GRAVES A,et al. Improving stroke alert response time:applying quality improvement methodology to the inpatient neurologic emergency[J]. J Hosp Med,2012,7(2):137-141. [51] CUMBLER E. In-hospital ischemic stroke[J]. Neurohospitalist,2015,5(3):173-181. [52] 张聪聪,楼敏,陈智才,等. 医院内缺血性脑卒中患者静脉溶栓时间及预后分析[J]. 浙江大学学报(医学版),2019,48(3):260-266. [53] 周建波,周璐芬,杨小华. 院内急性缺血性卒中血管内治疗延误现状及对策分析[J]. 神经损伤与功能重建,2020,15(12):740-741. [54] 邱凯,施海彬,祖庆泉,等. 机械取栓治疗院内外急性缺血性脑卒中疗效的倾向性匹配研究[J]. 中华放射学杂志,2020,54(4):360-363. [55] 李光建,史树贵,周振华,等. 院内卒中救治绿色通道建立、优化及区域救治网络的建立[J]. 中国卒中杂志,2018,13(2):127-131. [56] 周立新,倪俊. 院内缺血性卒中的诊疗现状与挑战[J]. 中国卒中杂志,2020,17(2):74-81. [57] 文珊,史树贵,周振华,等. 支架取栓治疗中重度院内急性缺血性卒中的效果分析[J]. 第三军医大学学报,2018,40(6):507-512. [58] 刘钦晨,贾振宇,赵林波,等. 院内急性缺血性卒中血管内介入治疗延误的影响因素分析[J]. 中国卒中杂志,2015,15(8):876-880. [59] MANNERS J,KHANDKER N,BARRON A,et al. An interdisciplinary approach to inhospital stroke improves stroke detection and treatment time[J]. J Neurointerv Surg,2019,11(11):1080-1084. [60] NOLAN S,NAYLOR G,BURNS M. Code gray-an organized approach to inpatient stroke[J]. Crit Care Nurs Q,2003,26(4):296-302. [61] PINES A R,DAS D M,BHATT S K,et al. Identifying and addressing barriers to systemic thrombolysis for acute ischemic stroke in the inpatient setting:a quality improvement initiative[J]. Mayo Clin Proc Innov Qual Outcomes,2020,4(6):657-666. [62] MELLON L,HASAN H,LEE S,et al. Knowledge of thrombolytic therapy amongst hospital staff:preliminary results and treatment implications[J]. Stroke,2015,46(12):3551-3553. [63] CHANG P,RUFF I,MENDELSON S J,et al. The 2CAN score development of a novel inpatient stroke detection tool[J]. Stroke,2018,49(12):2866-2871. [64] EL AMMAR F,ARDELT A,DEL BRUTTO V J,et al. BE-FAST:a sensitive screening tool to identify in-hospital acute ischemic stroke[J/OL]. J Stroke Cerebrovasc Dis,2020,29(7):104821[2022-04-10]. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104821. [65] WILKINSON C M,BURRELL J I,KUZIEK J W P,et al. Predicting stroke severity with a 3-min recording from the muse portable EEG system for rapid diagnosis of stroke[J/OL]. Sci Rep,2020,10(1):18465[2022-04-10]. https://doi.org/10.1038/s41598-020-75379-w. [66] DROEGEMUELLER C J,KASHYAP B,HUNA WAGNER R L,et al. A successful quality improvement project for detection and management of acute stroke in hospitalized patients[J]. J Neurosci Nurs,2020,52(4):186-191. [67] CHAO B H,YAN F,HUA Y,et al. Stroke prevention and control system in China:CSPPC-stroke program[J]. Int J Stroke,2021,16(3):265-272. [68] CHERNYSHEV Q Y,MARTIN-SCHILD S,ALBRIGHT K C,et al. Safety of tPA in stroke mimics and neuroimaging-negative cerebral ischemia[J]. Neurology,2010,74(17):1340-1345. [69] YOO J,SONG D,BAEK J H,et al. Comprehensive code stroke program to reduce reperfusion delay for in-hospital stroke patients[J]. Int J Stroke,2016,11(6):656-662. [70] 缪中荣,霍晓川. 未来已来:急性缺血性卒中血管内治疗中国现状[J]. 中国卒中杂志,2021,16(11):1085-1090. |
[1] | 曹黎明, 任力杰. 急性缺血性卒中诊疗技术的进展与展望[J]. 中国卒中杂志, 2024, 19(9): 983-989. |
[2] | 符鹏程, 曹黎明, 朱佳倩, 赵桂玉, 徐格林. 大动脉粥样硬化性缺血性卒中再灌注治疗的研究进展[J]. 中国卒中杂志, 2024, 19(9): 1004-1011. |
[3] | 张丽苹, 曹黎明, 肖楠, 廖雨琦, 池枫, 余艳妮, 任力杰. 纳米材料在缺血性卒中诊疗中的研究进展及挑战[J]. 中国卒中杂志, 2024, 19(9): 1012-1017. |
[4] | 王晓蕊, 骆嵩, 邹良玉, 屈洪党, 崔雪, 赵玉洁. 嗜酸性粒细胞与单核细胞比值预测急性缺血性卒中患者静脉溶栓预后的价值研究 [J]. 中国卒中杂志, 2024, 19(9): 1025-1033. |
[5] | 王铄, 余苹, 张宁, 王春雪. 2013—2023年缺血性卒中与睡眠相关性研究的文献计量学分析 [J]. 中国卒中杂志, 2024, 19(9): 1040-1047. |
[6] | 周宏宇, 李子孝, 王拥军. 基于影像组学预测大脑年龄与缺血性卒中的研究进展[J]. 中国卒中杂志, 2024, 19(9): 1066-1076. |
[7] | 阿娜古丽·阿不拉尼压孜, 吴晓欣, 李骄星, 李竹浩, 盛文利. 急性缺血性卒中磁敏感血管征影响因素及临床应用的研究进展[J]. 中国卒中杂志, 2024, 19(9): 1077-1085. |
[8] | 杨金波, 张聪. 高分辨率血管壁成像在缺血性卒中患者中的应用进展[J]. 中国卒中杂志, 2024, 19(9): 1086-1093. |
[9] | 吴春艳, 尹雅诗, 王广志, 岳奎涛. 急性缺血性卒中不同时间窗影像学评价及应用进展[J]. 中国卒中杂志, 2024, 19(9): 1094-1101. |
[10] | 张梦若, 徐守臣, 隋翠翠, 李玉奎, 王雪莉. 下肢康复机器人联合头针治疗对老年缺血性卒中患者步行效率和协调功能影响调查 [J]. 中国卒中杂志, 2024, 19(8): 902-908. |
[11] | 吴娱倩, 张玉梅, 臧大维, 范小伟, 王安心, 张晓丽, 孟霞. 上肢动作研究测试量表评定亚急性期缺血性卒中患者偏瘫侧上肢及手功能的信效度和敏感性研究 [J]. 中国卒中杂志, 2024, 19(8): 915-923. |
[12] | 莫秋红, 丁晓波, 李靓, 张岩波, 李伟荣. 基于可解释性机器学习模型的轻型缺血性卒中复发预测研究[J]. 中国卒中杂志, 2024, 19(8): 924-930. |
[13] | 逯丹, 陈玮琪, 王雅平, 段婉莹, 郭蕾, 王玲, 刘丽萍, 徐安定, 王拥军, 中国卒中学会脑保护圆桌会学术委员会. 缺血性卒中脑细胞保护科学声明——来自中国卒中学会的科学声明 [J]. 中国卒中杂志, 2024, 19(8): 938-955. |
[14] | 李光硕, 赵性泉. 《中国急性缺血性卒中诊治指南2023》解读[J]. 中国卒中杂志, 2024, 19(8): 956-961. |
[15] | 白磊鹏, 罗杰, 周思捷, 黄健辉, 梁铭钦, 赵庆顺. 肺叶楔形切除术后并发急性缺血性卒中行介入取栓治疗2例并文献回顾 [J]. 中国卒中杂志, 2024, 19(8): 962-966. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||