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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Emergency Physician Attitudes Toward Thrombolytic Therapy in Acute Stroke
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Emergency Physician Attitudes Toward Thrombolytic Therapy in Acute Stroke

机译：急诊医师对急性脑卒中溶栓治疗的态度

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Background: Intravenous use of tissue plasminogen activator (TPA) is the only currently approved treatment for acute ischemic stroke. Methods: To determine emergency physician attitudes and practices with regard to thrombolysis for ischemic stroke, a questionnaire was sent to program directors of accredited emergency medicine residencies in the United States. Results: There were 73 program directors who responded to the survey; 71% of medical centers have used TPA for treatment of stroke. The reported major complication rate for cerebral hemorrhage and death averaged 7%. For nontreating centers, two major factors cited were lack of appropriate patients and concerns regarding the safety of TPA; 48% of the facilities do not have an acute stroke team. Delayed patient arrival and the perceived narrow risk/benefit ratio of TPA were identified as the two greatest obstacles to more widespread use of TPA. Conclusion: Although the majority of medical centers that responded in this study have some experience with thrombolytic therapy for acute ischemic stroke, almost one half do not have an acute stroke team and considerable uncertainty exists regarding the safety of intravenous TPA. More uniform national treatment of acute stroke will require greater consensus among emergency physicians and further analysis of the risk/benefit ratio of thrombolytic treatment.
机译：背景：静脉使用组织纤溶酶原激活剂（TPA）是目前唯一批准的急性缺血性卒中治疗方法。方法：为了确定急诊医师对缺血性卒中溶栓治疗的态度和做法，向美国经认可的急诊医学住院医师的计划主管发送了问卷。结果：有73位计划负责人回答了该调查。 71％的医疗中心已使用TPA治疗中风。报道的脑出血和死亡的主要并发症平均发生率为7％。对于非治疗中心，提到的两个主要因素是缺乏合适的患者和对TPA安全性的担忧。 48％的设施没有急性中风队。延迟的患者到达和TPA的狭窄的风险/收益比被认为是TPA广泛使用的两个最大障碍。结论：尽管在本研究中做出反应的大多数医疗中心都具有针对急性缺血性中风的溶栓治疗的经验，但几乎有一半没有急性中风的团队，并且关于静脉内TPA的安全性存在相当大的不确定性。急性卒中的全国统一治疗将需要急诊医师之间达成更大共识，并需要进一步分析溶栓治疗的风险/获益比。

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