5G移动卒中单元在卒中筛查和急诊救治中的应用分析  

Application analysis of 5G mobile stroke unit in stroke screening and emergency treatment

作　　者：李智强 郭松韬 徐如祥[2] 张洪钿 李方睿 王艳霞 杨丽荣 包成月 吴喜 暴秀颖 尹晓亮 韩芸峰[3] Li Zhiqiang;Guo Songtao;Xu Ruxiang;Zhang Hongdian;Li Fangrui;Wang Yanxia;Yang Lirong;Bao Chengyue;Wu Xi;Bao Xiuying;Yin Xiaoliang;Han Yunfeng(Department of Neurosurgery,Xing'an League People's Hospital,Ulanhot 137400,China;Department of Neurosurgery,the Seventh Medical Center,PLA General Hospital,Beijing 100853,China;Department of Neurosurgery,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]兴安盟人民医院神经外科,乌兰浩特137400 [2]解放军总医院第七医学中心神经外科,北京100853 [3]北京大学第三医院神经外科,100191

出　　处：《中华神经外科杂志》2021年第9期908-912,共5页Chinese Journal of Neurosurgery

基　　金：内蒙古自治区科技创新引导项目(KC2021002);中央引导地方科技发展资金(2017ZY0018)。

摘　　要：目的探讨第五代移动通信技术(简称5G)移动卒中单元在卒中筛查和急诊救治中的应用情况。方法回顾性分析2020年10月至2021年1月兴安盟人民医院卒中中心采用5G移动卒中单元进行义诊筛查和急诊救治的结果。对于义诊筛查出的卒中中高危患者酌情予以对症治疗和健康宣教,并嘱其监测血压等,定期行影像学随访;对于急诊救治的患者即刻实时远程会诊,并制定抢救策略,急性脑梗死可就地实施溶栓治疗,治疗后均行临床和影像学随访,并采用格拉斯哥预后评级(GOS)评估预后。结果义诊筛查共筛出173例患者,其中低危卒中患者98例(56.6%),中高危卒中患者75例(43.4%)。共急诊救治44例患者,其中缺血性卒中25例,出血性卒中11例,其他7例,1例死亡患者未行头颅CT检查。患者自呼救至5G移动卒中救护车的中位时间为71min(9~167 min);患者进入救护车至开始头颅CT扫描的中位时间为5 min(1~31 min)。其中5例缺血性卒中患者在救护车上进行溶栓治疗。43例急诊救治的患者3个月随访显示,25例缺血性卒中患者中5例溶栓者的GOS均为Ⅴ级,头颅CT显示脑梗死区明显缩小或消失;20例未行溶栓治疗的患者中,有效随访18例,其中GOSⅠ级1例、Ⅲ级9例、Ⅳ级3例、Ⅴ级5例,头颅CT显示脑梗死区软化灶无明显变化。11例出血性卒中患者中,GOSⅠ级2例、Ⅲ级3例、Ⅳ级4例、Ⅴ级2例,头颅CT显示出血区形成软化灶。结论5G移动卒中单元应用于义诊时,较易筛查出中高危卒中患者;在急诊救治时,可缩短卒中的救治时间,确保患者在时间窗内得到有效救治。Objective To explore the application of 5G mobile stroke unit in the diagnosis screening and emergency treatment of stroke.Methods The results of free diagnosis screening and treatment of 5G mobile stroke unit at the Stroke Center of Xing'an League People's Hospital from October 2020 to January 2021 were retrospectively analyzed.Symptomatic treatment and health education were given to high-risk stroke patients identified by free diagnosis screening,who were instructed to monitor the blood pressure,and regular imaging reexamination was performed.Immediate real-time remote consultation was conducted or emergency patients and rescue strategies were formulated.Intravenous thrombolysis was performed on the spot for acute cerebral infarction.Patients treated in the emergency department were followed up clinically and radiologically,and their outcomes were assessed based on the Glasgow Outcome Scale(GOS).Results A total of 173 patients were identified during screening,including 98 patients(56.6%)with low risk stroke and 75 patients(43.4%)with medium and high risk stroke.Forty-four patients were treated at the emergency department,including 25 cases of ischemic stroke,11 cases of hemorrhagic stroke,7 cases of others and 1 case of death without CT examination.The median time from the patient's call for help to reaching the 5G mobile stroke ambulance was 71 min(9-167 minutes);the median time between admission to the ambulance and the start of CT scan was 5 min(1-31 min).Five out of those patients with ischemic stroke received intravenous thrombolysis in an ambulance.The 3-month follow-up of 43 emergency patients showed that the GOS of 5 out of 25 ischemic stroke patients undergoing thrombolysis was grade Ⅴ,and the head CT showed that the cerebral infarction area was significantly smaller or disappeared.Among the 20 patients who did not receive thrombolysis,18 cases were successfully followed up and included 1 case of GOS grade Ⅰ,9 cases of grade Ⅲ,3 cases of grade Ⅳ,and 5 cases of grade Ⅴ.The head CT showed no si

关 键 词：卒中 远程医学 诊断 第五代移动通信技术 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]