Xiaoting Zhu, Rong Niu, Fangfang Bai, Zhufeng Zhang
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引用次数: 0
摘要
目的:系统评价院前、院内急救模式在急性脑卒中患者中的应用效果。本研究通过系统检索中文(CNKI、万方和VIP)和英文(PubMed、EMBASE和Cochrane Library)数据库进行。本研究纳入了比较院前和院内急救模式在急性脑卒中患者中的作用的病例对照研究。结局指标包括入院至溶栓治疗时间(DNT)、报警至专业治疗时间、急救效果(有效率、致残率、死亡率)、并发症及预后。采用RevMan 5.3进行meta分析。17项研究被纳入最终分析。与传统急救措施相比,院前与院内急救措施可显著降低患者DNT(平均差值[MD] = -22.63, p < 0.00001)、呼叫至专业治疗时间(MD: -13.22, p < 0.00001)、致残率(RR = 0.88, p = 0.004)、病死率(RR = 0.58, p < 0.00001)、中脑发热(RR = 0.44, p = 0.0009)、胃肠道出血(RR = 0.44, p = 0.002)。此外,日常生活能力(MD = 16.56, p < 0.00001)和应急反应率(RR = 1.50, p < 0.00001)均显著提高。院前院内急救模式对急性脑卒中患者的急救效果显著,是一个保护因素。这种应急模式可广泛应用于临床。
The application of pre-hospital first aid mode in patients with acute stroke: meta-analysis.
To systematically evaluate the application effect of pre-hospital and in-hospital emergency mode in patients with acute stroke. The study was conducted by systematic search of Chinese (CNKI, Wanfang and VIP) and English (PubMed, EMBASE and Cochrane Library) databases. The case-control studies comparing the role of pre-hospital and in-hospital emergency mode for patients with acute stroke were included in this study. Outcome indicators included the time from admission to thrombolytic therapy (DNT), the time from calling for help to receiving professional treatment, the first aid effect (effective rate, disability rate and mortality), complications and prognosis. Meta-analysis was performed using RevMan 5.3. Seventeen studies were included in the final analysis. Compared with traditional emergency measures, pre-hospital and in-hospital emergency measures can significantly reduce DNT (mean difference [MD] = -22.63, p < 0.00001), time from call to professional treatment (MD: -13.22, p < 0.00001), disability rate (RR = 0.88, p = 0.004), fatality rate (RR = 0.58, p < 0.00001), central cerebral fever (RR = 0.44, p = 0.0009), and gastrointestinal bleeding (RR = 0.44, p = 0.002). In addition, daily living ability (MD = 16.56, p < 0.00001) and emergency response rate (RR = 1.50, p < 0.00001) were significantly improved. The pre-hospital and in-hospital emergency mode has a significant emergency effect in patients with acute stroke, which is a protective factor. This emergency mode can be widely used in clinical practice.
期刊介绍:
Folia Neuropathologica is an official journal of the Mossakowski Medical Research Centre Polish Academy of Sciences and the Polish Association of Neuropathologists. The journal publishes original articles and reviews that deal with all aspects of clinical and experimental neuropathology and related fields of neuroscience research. The scope of journal includes surgical and experimental pathomorphology, ultrastructure, immunohistochemistry, biochemistry and molecular biology of the nervous tissue. Papers on surgical neuropathology and neuroimaging are also welcome. The reports in other fields relevant to the understanding of human neuropathology might be considered.