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JAMA Neurol:院前强化护理对中风患者溶栓率的影响

2020-04-14 MedSci原创 MedSci原创

加强入院前护理评估对中风患者入院溶栓率无显著影响

快速溶栓治疗降低了急性缺血性脑卒中患者致残风险,近日研究人员考察了强化急性脑卒中辅助治疗评估(PASTA)干预对医院溶栓率的影响。
 
研究在2015-2018年间开展, 3家救护车服务机构和15家医院参与。救护站的医护人员,预先随机分配到PASTA或标准护理。PASTA干预措施包括额外的院前信息收集、结构化的医院交接、在交接后15分钟内的实际援助、出发前的护理清单和临床医师的反馈。研究的主要结果是接受溶栓治疗的患者比例。次要结果包括时间间隔和第90天的健康状况(不良预后定义为修正的Rankin评分>2)。
 
1214名患者参与评估,患者平均年龄74.7岁,590名女性(48.6%),500名患者由242名接受过PASTA干预培训的医护人员进行诊治,714名患者由355名接受过中风标准护理指南的医护人员进行诊治。接受过PASTA干预培训的医护人员完成患者护理事件的平均时间延长了13.4分钟。PASTA组的患者溶栓率较低,但无显著性差异(PASTA组,500例患者中197例[39.4%]vs标准治疗组,714例患者中319例[44.7%];校正比值比:0.81)。护理人员到达现场到溶栓的时间,PASTA组(98.1分钟)比标准护理组(89.4分钟)平均延长8.5分钟。PASTA组患者不良预后率较低,但差异不显著(64.0% vs 66.8%;校正比值比为0.86)。
 
研究认为,加强入院前护理评估对中风患者入院溶栓率无显著影响。
 
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  2. [GetPortalCommentsPageByObjectIdResponse(id=1769982, encodeId=d7911e69982bc, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Mon Jul 20 21:27:09 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001022, encodeId=3c902001022e2, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Oct 05 06:27:09 CST 2020, time=2020-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538092, encodeId=aa1f153809203, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Thu Apr 16 10:27:09 CST 2020, time=2020-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036036, encodeId=850c1036036fe, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045957, encodeId=6286104595e28, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=)]
    2020-10-05 yinhl1978
  3. [GetPortalCommentsPageByObjectIdResponse(id=1769982, encodeId=d7911e69982bc, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Mon Jul 20 21:27:09 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001022, encodeId=3c902001022e2, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Oct 05 06:27:09 CST 2020, time=2020-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538092, encodeId=aa1f153809203, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Thu Apr 16 10:27:09 CST 2020, time=2020-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036036, encodeId=850c1036036fe, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045957, encodeId=6286104595e28, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1769982, encodeId=d7911e69982bc, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Mon Jul 20 21:27:09 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001022, encodeId=3c902001022e2, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Oct 05 06:27:09 CST 2020, time=2020-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538092, encodeId=aa1f153809203, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Thu Apr 16 10:27:09 CST 2020, time=2020-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036036, encodeId=850c1036036fe, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045957, encodeId=6286104595e28, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=)]
    2020-04-14 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1769982, encodeId=d7911e69982bc, content=<a href='/topic/show?id=51469830949' target=_blank style='color:#2F92EE;'>#院前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98309, encryptionId=51469830949, topicName=院前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c5ca38130612, createdName=mhzhuang@stu.e, createdTime=Mon Jul 20 21:27:09 CST 2020, time=2020-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001022, encodeId=3c902001022e2, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Mon Oct 05 06:27:09 CST 2020, time=2020-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1538092, encodeId=aa1f153809203, content=<a href='/topic/show?id=e835226210e' target=_blank style='color:#2F92EE;'>#中风患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22621, encryptionId=e835226210e, topicName=中风患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1b5612933772, createdName=sunylz, createdTime=Thu Apr 16 10:27:09 CST 2020, time=2020-04-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036036, encodeId=850c1036036fe, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045957, encodeId=6286104595e28, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Apr 14 22:27:09 CST 2020, time=2020-04-14, status=1, ipAttribution=)]
    2020-04-14 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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