結合決策支援能力於開發評估急性缺血性腦中風病患之醫療資訊系統

中風是老年人中非常常見的疾病，而急性缺血性腦中風又是台灣老年人口中嚴重的殺手。而血栓溶解劑治療急性缺血性腦中風的特效藥，然而若使用時機不當，則可能增加副作用。根據歐美學者使用rt-PA 的經驗，若使用於發病超過3 小時的患者，則病人產生腦出血的機率大增(3小時以內增加6%，6 小時以內增加14%)。雖然使用rt-PA可治癒大約三分之一的患者，獲得完全的康復。但若未依正確的臨床治療流程，則治療過程亦可能伴隨潛在危險。為了提高rtpa用藥的安全及保障病人的健康，這個研究就開發了行動平台上的腦中風醫療資訊系統。這個系統包括了腦中風用藥的評估的流程及標準程序，臨床醫生可以用來決定是否可以施打rtpa。決策支援能力已結合在此系統中，臨床上已證明本系統的用處及保障急性缺血性腦中風病人的安全。

關鍵字

醫療資訊系統；中風；血栓溶解劑；行動資訊平台

並列摘要

The stroke is a very common disease occurred among the aged people. It is also referred as acute ischemic stroke, and is a leading death to aged population in Taiwan. The “recombinant t-PA” (also known as the rt-PA) has been known as a specific remedy to treat the patients with acute ischemic stroke. However, if this is improperly used, considerable side effects could occur. According to the clinical experience of using rt-PA in US and European, if the medicine is used after the first 3 hours since the stroke strikes, the probability of brain hemorrhagic will raise significantly (6% in 3 hours, 14% in 6 hours). Even though using rt-PA can cure acute almost 1/3 of patients with ischemic stroke completely, the potential danger still exist if the standard procedures are not followed. To enhance the drug-used safety and to raise patient’s health, a medical informatics system is developed on the mobile device. This system provides evaluation process and standard procedures so that the physician can follow and make decision whether the rtpa should be used. The decision support capability is embedded, and this system has been tested and proved to be useful to protect stroke patients.