- 期刊
Evaluation of Pre-Hospital and Emergency Department Delays in Acute Ischemic Stroke-A Hospital-Based Study
急性缺血性腦中風病患到院前與急診部延誤時間之分析－以某醫學中心為例
摘要
目的 證據顯示，及時的血栓溶解治療可以改善急性缺血性腦中風病患的預後，減少後遺症。今年初台灣剛剛通過對於中風的血栓溶解治療，但目前還很少病人接受這樣的治療。本研究的目的是分析急性缺血性腦中風病患到院前，以及到院後處置所需時間，以作為將來推動血栓溶解治療的參考。 方法 這是以台彎中部某醫學中心急診室為病人樣本來源的回溯性調查，以疾病分類代碼（ICD－9CM）為基礎，調出診斷為缺血性腦中風，並從急診收入神經內科病房住院的病人之病歷，根據ACLS2000的建議，篩選出適合做血栓溶解治療的病患，依時問序列進行分析。 結果 從2002年1月到12月，總共有212人納入本研究，其中男性佔126人（59.4%)，女性佔86人（40.6%)，只有44人（20.8%）能夠及時在120分鐘內抵達醫院的急診室。其中只有26人（12.3%，26/212）利用EMS抵達急診部，EMS輸送病人的平均時間為26.0士22.5分鐘。 結論 若要廣泛推行血栓溶解治療，除了必須調整院內作業流程之外，更重要的是必須教導民眾關於中風的相關症狀，並強調及時至急診室就醫的重要性。
並列摘要
Objectives. Evidence suggests that thrombolytic treatment reduces the morbidity and mortality associated with acute ischemic stroke; however, thrombolysis has only recently been approved for use in Taiwan. This study aimed to assess pre-hospital delays and Emergency Department(ED) delays in anticipation of the eventual introduction of thrombolytic treatment in Taiwan. Methods. This was a hospital-based retrospective study. A total of 651 patients with acute ischemic stroke admitted to the ED from January 2002 to December 2002, were selected by ICD-9CM codes and analyzed in a time series. Patients who were referred to our institute or had incomplete data were excluded from the study. Results. A total of 212 patients, 126 (59.4%) men and 86 (40.6%) women, were considered suitable for thrombolytic treatment. Only 44 patients (20.8%) were sent to the ED within 120 min of stroke onset and only 26 patients (12.3%, 26/212) were transported by the emergency medical service (EMS). The average transportation time by EMS was 26.0+22.5 min. Conclusions. There is an urgent need to educate the public about thrombolytic treatment for stroke and to immediately evaluate patients when warning signs develop.
延伸閱讀
- Chan, L., & Chen, K. R. (2020). 急性缺血性中風患者的就醫決策軌跡. 台灣中風醫誌, 2(2), 146-159. https://doi.org/10.6318/FJS.202006_2(2).0006
- 王雲充、吳至翔（2022）。【論文摘要】探討急性腦中風病人住院期間接受物理治療之時機、出席頻率與治療強度。物理治療，47(4)，316-317。https://doi.org/10.6215/FJPT.202212.P27
- 唐于絢、黃郁文、陳琳嬿、劉春卿、吳淑蓉（2009）。急性缺血性腦中風病患急診就醫流程改善方案。新臺北護理期刊，11(1)，61-71。https://doi.org/10.6540/NTJN.2009.1.007
- 江俊宜、賴昱樺、熊光華、黃建華、彭家勛、陳建生、陳穎信（2010）。整合到院前及到院後急性缺血性腦中風溶栓照護以北臺灣為例：前趨研究。台灣急診專科醫師期刊，2(3)，74-82。https://doi.org/10.29749/JTCEP.201009.0002
- 張英明、陳品玲、胡朝榮、游家銘、吳柏瑞、陳俊亨（2005）。某區域醫院急性缺血性腦中風之醫療成本。北市醫學雜誌，2(3)，286-292。https://doi.org/10.6200/TCMJ.2005.2.3.08