分级诊疗下社区医院颈动脉超声筛查脑卒中高危患者的应用价值  

Application value of carotid ultrasonography in screening high-risk stroke patients in community hospitals under hierarchical diagnosis and treatment

作　　者：李明辉 白文坤[2] 顾艳婷 LI Minghui;BAI Wenkun;GU Yanting(Ultrasound Department of Wuqiao Community Health Service Center of Zhuanghang Town of Fengxian District,Shanghai 201412,China;Department of Ultrasound in Medicine of Sixth People’s Hospital affiliated to Shanghai Jiao Tong University,Shanghai 200233,China)

机构地区：[1]上海市奉贤区庄行镇邬桥社区卫生服务中心超声科,上海201402 [2]上海交通大学附属第六人民医院超声医学科,上海200233

出　　处：《上海医药》2020年第24期30-32,49,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:探讨分级诊疗下社区医院使用颈动脉超声筛查脑卒中高危患者的应用价值。方法:选取脑卒中患者80例作为观察组,同时选取无脑卒中患者80例作为对照组。两组均行颈动脉超声检查,统计斑块厚度、分布、声像类型和狭窄程度,比较不同类型斑块对脑卒中发生的影响。结果:观察组患者均有不同程度斑块,检出率为100%,斑块以多发性为主,分布部位以颈总动脉分叉处最多;软斑48个,硬斑39个,溃疡斑46个;颈动脉完全闭塞0例,50%以上狭窄26例,50%以下狭窄54例。对照组中检出颈动脉斑块20例,检出率为25%,斑块多以硬斑为主,分布部位以颈总动脉分叉处最多;软斑2个,硬斑17个,溃疡斑1个;颈动脉完全闭塞0例,50%以上狭窄0例,50%以下狭窄20例。观察组软斑比例、硬斑比例、溃疡斑比例均高于对照组(P<0.05)。结论:用颈动脉超声筛查脑卒中高危患者可做到早发现、早诊断、早治疗,适于在社区医院推广。Objective:To explore the application value of carotid ultrasonography in screening high-risk stroke patients in community hospitals under hierarchical diagnosis treatment.Methods:Eighty stroke patients were selected as an observation group,and at the same time,and eighty patients without stroke were selected as a control group.Carotid ultrasound examination was performed in both groups,and the thickness,distribution,type and degree of stenosis of plaques were counted,and the influence of different types of plaques on the occurrence of stroke was compared.Results:All patients in the observation group had plaques of different degrees,and the detection rate was 100%,most of the plaques were multiple,and the distribution of plaques was at the bifurcation of the common carotid artery;there were 48 soft spots,39 hard spots and 46 ulcer spots;there were 0 cases of complete occlusion of carotid artery,26 cases of more than 50%stenosis and 54 cases of less than 50%stenosis.In the control group,20 cases of carotid plaque were detected,the detection rate was 25%,most of the plaques were hard plaques,most of which were located at the bifurcation of the common carotid artery;there were 2 soft spots,17 hard spots and 1 ulcer spot;there were 0 cases with complete carotid occlusion,0 cases with stenosis above 50%,and 20 cases with stenosis below 50%.The proportions of soft spots,hard spots and ulcer spots in the observation group were higher than those in the control group(P<0.05).Conclusion:Carotid ultrasound screening of high-risk patients with stroke can achieve early detection,early diagnosis and early treatment,which is suitable for promotion in community hospitals.

关 键 词：脑卒中 超声检查 颈动脉斑块 分级诊疗 

分 类 号：R445.1[医药卫生—影像医学与核医学]