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Neurology: 为了溶栓,到底要不要行胸片检查?

2016-10-25 MedSci MedSci原创

目的:使用大型的多中心临床试验的数据评估胸片(CXR)急性缺血性卒中早期评估中的意义和作用。方法: 记录初期评估CXR检查患者的临床特征。研究者比较IV溶栓前和未进行IV溶栓的CXR的临床特点。研究者比较两组间不良心脏事件,插管,住院死亡率。应用Logistic回归分析评估CXR与入院到治疗时间超过60分钟的相关性。结果:队列中共有615例患者,243例在IV溶栓前行胸片检查。治疗前行胸片检查的患

目的:使用大型的多中心临床试验的数据评估胸片(CXR)急性缺血性卒中早期评估中的意义和作用。

方法: 记录初期评估CXR检查患者的临床特征。研究者比较IV溶栓前和未进行IV溶栓的CXR
的临床特点。研究者比较两组间不良心脏事件,插管,住院死亡率。应用Logistic回归分析评估CXR与入院到治疗时间超过60分钟的相关性。

结果:队列中共有615例患者,243例在IV溶栓前行胸片检查。治疗前行胸片检查的患者入院神经功能缺损严重程度,初始呼吸频率,入院到治疗时间超过治疗后行CXR。两组间入院24小时内不良心脏事件的发生率,在第一个7小时气管插管,及住院死亡率之间无显著差异。治疗前行胸片检查,入院到治疗的时间更长。(75.8 vs 58.3min)。CXR与入院到治疗时间超过60min相关(OR 2.78,95%CI:1.97-3.92)。

结论:急性缺血性卒中患者静脉溶栓前行CXR治疗可延长入院到治疗的时间。如患者存在急性心肺症状等影响IV溶栓或影响管理的情况,静脉溶栓前应行CXR检查。

原始出处:


Saber H, Silver B, et al. Role of emergent chest radiography in evaluation of hyperacute stroke. Neurology. 2016 Aug 23.


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1999764, encodeId=ea7f1999e64ec, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 15 07:28:00 CST 2017, time=2017-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153655, encodeId=3726153655c0, content=真的有用,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:14:20 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153654, encodeId=6b151536545f, content=受益匪浅,学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:13:09 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153653, encodeId=1ae615365398, content=以后注意相关的辅助检查, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:12:44 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446863, encodeId=3f8314468631e, content=<a href='/topic/show?id=293484132b0' target=_blank style='color:#2F92EE;'>#胸片#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84132, encryptionId=293484132b0, topicName=胸片)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKLKvGibqOiaS8aNUxicnauicTrMjGzKpNxGK8emxaZH22OeU4sEOujftNY904T6neAvAbLXOKONlZziaQ/132, createdBy=3c605291750, createdName=hukaixun, createdTime=Thu Oct 27 07:28:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151189, encodeId=667715118993, content=学习了,之后注意查胸片, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Oct 25 21:53:58 CST 2016, time=2016-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151152, encodeId=d8c915115207, content=说得很有道理, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161024/IMG580E2637B3FB86199.jpg, createdBy=3b491964393, createdName=小袁医生, createdTime=Tue Oct 25 18:17:29 CST 2016, time=2016-10-25, status=1, ipAttribution=)]
    2017-07-15 yinhl1978
  2. [GetPortalCommentsPageByObjectIdResponse(id=1999764, encodeId=ea7f1999e64ec, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 15 07:28:00 CST 2017, time=2017-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153655, encodeId=3726153655c0, content=真的有用,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:14:20 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153654, encodeId=6b151536545f, content=受益匪浅,学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:13:09 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153653, encodeId=1ae615365398, content=以后注意相关的辅助检查, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:12:44 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446863, encodeId=3f8314468631e, content=<a href='/topic/show?id=293484132b0' target=_blank style='color:#2F92EE;'>#胸片#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84132, encryptionId=293484132b0, topicName=胸片)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKLKvGibqOiaS8aNUxicnauicTrMjGzKpNxGK8emxaZH22OeU4sEOujftNY904T6neAvAbLXOKONlZziaQ/132, createdBy=3c605291750, createdName=hukaixun, createdTime=Thu Oct 27 07:28:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151189, encodeId=667715118993, content=学习了,之后注意查胸片, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Oct 25 21:53:58 CST 2016, time=2016-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151152, encodeId=d8c915115207, content=说得很有道理, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161024/IMG580E2637B3FB86199.jpg, createdBy=3b491964393, createdName=小袁医生, createdTime=Tue Oct 25 18:17:29 CST 2016, time=2016-10-25, status=1, ipAttribution=)]
    2016-11-05 往日如昨

    真的有用,学习了

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1999764, encodeId=ea7f1999e64ec, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 15 07:28:00 CST 2017, time=2017-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153655, encodeId=3726153655c0, content=真的有用,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:14:20 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153654, encodeId=6b151536545f, content=受益匪浅,学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:13:09 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153653, encodeId=1ae615365398, content=以后注意相关的辅助检查, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:12:44 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446863, encodeId=3f8314468631e, content=<a href='/topic/show?id=293484132b0' target=_blank style='color:#2F92EE;'>#胸片#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84132, encryptionId=293484132b0, topicName=胸片)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKLKvGibqOiaS8aNUxicnauicTrMjGzKpNxGK8emxaZH22OeU4sEOujftNY904T6neAvAbLXOKONlZziaQ/132, createdBy=3c605291750, createdName=hukaixun, createdTime=Thu Oct 27 07:28:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151189, encodeId=667715118993, content=学习了,之后注意查胸片, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Oct 25 21:53:58 CST 2016, time=2016-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151152, encodeId=d8c915115207, content=说得很有道理, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161024/IMG580E2637B3FB86199.jpg, createdBy=3b491964393, createdName=小袁医生, createdTime=Tue Oct 25 18:17:29 CST 2016, time=2016-10-25, status=1, ipAttribution=)]
    2016-11-05 往日如昨

    受益匪浅,学习到了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1999764, encodeId=ea7f1999e64ec, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 15 07:28:00 CST 2017, time=2017-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153655, encodeId=3726153655c0, content=真的有用,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:14:20 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153654, encodeId=6b151536545f, content=受益匪浅,学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:13:09 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153653, encodeId=1ae615365398, content=以后注意相关的辅助检查, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:12:44 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446863, encodeId=3f8314468631e, content=<a href='/topic/show?id=293484132b0' target=_blank style='color:#2F92EE;'>#胸片#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84132, encryptionId=293484132b0, topicName=胸片)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKLKvGibqOiaS8aNUxicnauicTrMjGzKpNxGK8emxaZH22OeU4sEOujftNY904T6neAvAbLXOKONlZziaQ/132, createdBy=3c605291750, createdName=hukaixun, createdTime=Thu Oct 27 07:28:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151189, encodeId=667715118993, content=学习了,之后注意查胸片, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Oct 25 21:53:58 CST 2016, time=2016-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151152, encodeId=d8c915115207, content=说得很有道理, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161024/IMG580E2637B3FB86199.jpg, createdBy=3b491964393, createdName=小袁医生, createdTime=Tue Oct 25 18:17:29 CST 2016, time=2016-10-25, status=1, ipAttribution=)]
    2016-11-05 往日如昨

    以后注意相关的辅助检查

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1999764, encodeId=ea7f1999e64ec, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Sat Jul 15 07:28:00 CST 2017, time=2017-07-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153655, encodeId=3726153655c0, content=真的有用,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:14:20 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153654, encodeId=6b151536545f, content=受益匪浅,学习到了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:13:09 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=153653, encodeId=1ae615365398, content=以后注意相关的辅助检查, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0a61971598, createdName=往日如昨, createdTime=Sat Nov 05 18:12:44 CST 2016, time=2016-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446863, encodeId=3f8314468631e, content=<a href='/topic/show?id=293484132b0' target=_blank style='color:#2F92EE;'>#胸片#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84132, encryptionId=293484132b0, topicName=胸片)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/PiajxSqBRaEKLKvGibqOiaS8aNUxicnauicTrMjGzKpNxGK8emxaZH22OeU4sEOujftNY904T6neAvAbLXOKONlZziaQ/132, createdBy=3c605291750, createdName=hukaixun, createdTime=Thu Oct 27 07:28:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151189, encodeId=667715118993, content=学习了,之后注意查胸片, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=445f1740270, createdName=meiliwuxian, createdTime=Tue Oct 25 21:53:58 CST 2016, time=2016-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=151152, encodeId=d8c915115207, content=说得很有道理, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20161024/IMG580E2637B3FB86199.jpg, createdBy=3b491964393, createdName=小袁医生, createdTime=Tue Oct 25 18:17:29 CST 2016, time=2016-10-25, status=1, ipAttribution=)]
    2016-10-27 hukaixun
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    2016-10-25 meiliwuxian

    学习了,之后注意查胸片

    0

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    2016-10-25 小袁医生

    说得很有道理

    0

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