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首页> 外文期刊>Iranian Journal of Neurology >Acute management of stroke in Iran: Obstacles and solutions
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Acute management of stroke in Iran: Obstacles and solutions

机译：伊朗急性中风的管理：障碍和解决方案

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Background: Stroke is among the leading causes of mortality and permanent disability in the world. Iran is located in the stroke belt and has a high age-adjusted stroke incidence rate. In this multistep prospective qualitative study, we aimed at investigating the status and challenges of stroke management in Iran and explore possible solutions.Methods: In the first and second phase, we attempted to define the status of stroke management in Iran by searching the relevant literature and conducting semi-structured interviews with health-care providers in thirteen hospitals located in seven large cities in Iran. In the third phase, we tried to recommend possible solutions based on international standards and experience, as well as interviews with stroke experts in Iran and the United States.Results: Little public awareness of stroke symptoms and its urgency, low prioritization for stroke management, and an inadequate number of stroke-ready hospitals are some of the major obstacles toward timely treatment of stroke in Iran. Every hospital in our pool except two hospitals had guideline-based algorithms for the administration of intravenous thrombolysis. However, there was no single call activation system for stroke alert. Data from some of the centers showed that hospital arrival of stroke patients to final decision-making took 116-160 minutes. Although there were four endovascular programs in our target areas, there was no center with 24-hour coverage.Conclusion: There are many challenges as well as potentials for improvement of stroke care in Iran. Improving public knowledge of stroke and establishing an organized and comprehensive stroke program in the hospitals will improve acute stroke management in Iran. The Iranian ministry of health should define and advocate the establishment of stroke centers, track the rate of death and disability from stroke, introduce pathways to improve the quality of stroke care through national data monitoring systems, and eliminate disparities in stroke care.
机译：背景：中风是世界上导致死亡和永久性残疾的主要原因之一。伊朗位于中风带，并且年龄调整后的中风发病率很高。在这项多步骤前瞻性定性研究中，我们旨在调查伊朗中风管理的现状和挑战，并探讨可能的解决方案。方法：在第一和第二阶段，我们试图通过搜索相关文献来确定伊朗中风管理的地位。并对位于伊朗七个大城市的13家医院的医疗保健提供者进行半结构化采访。在第三阶段中，我们试图根据国际标准和经验以及与伊朗和美国的中风专家的访谈，提出可能的解决方案。结果：公众对中风症状及其紧迫性的意识很少，对中风管理的重视程度较低，而且中风医院的数量不足是伊朗及时治疗中风的主要障碍。除两家医院外，我们游泳池中的每家医院都有基于指南的静脉溶栓治疗算法。但是，没有用于中风警报的单一呼叫激活系统。一些中心的数据显示，中风患者到达医院的最终决策时间为116-160分钟。尽管我们的目标区域有四个血管内计划，但没有一个中心可以提供24小时的服务。结论：在伊朗，中风护理存在许多挑战和改善潜力。提高公众对中风的认识并在医院中建立有组织的综合中风计划将改善伊朗的急性中风管理。伊朗卫生部应定义并倡导建立中风中心，跟踪中风导致的死亡和残疾率，通过国家数据监测系统引入改善中风护理质量的途径，并消除中风护理中的差异。

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