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Prehospital Thrombolysis: A Manual from Berlin
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在急诊室的眼球中风协议
Étienne Bénard-Séguin1, Fadi Nahab2, Andrew M Pendley3
1Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA.
概括
快速诊断视网膜动脉封闭 (RAO) 使用非脑膜底部摄影与光学连贯性断层扫描 (NMFP-OCT) 在急诊室改善患者的结果. 这种综合方法有助于早期发出中风预警和启动治疗.
科学领域:
- 眼科医生 眼科 眼科
- 紧急医疗 紧急医疗
- 脑卒中管理 脑卒中管理
背景情况:
- 由于诊断延迟,急性视网膜动脉阻塞 (RAO) 具有不良的视觉结果.
- 标准的急诊室 (ED) 缺乏光学连贯断层扫描 (OCT) 来检测超急性RAO.
- 与OCT相结合的非水眼底照片 (NMFP) 可以促进快速的远程诊断.
研究的目的:
- 评估NMFP-OCT对ED中急性中央和分支视网膜动脉封闭 (CRAO/BRAO) 的超快速远程诊断的实用性.
- 评估使用NMFP-OCT启动急性视力丧失中风预警和治疗方案的可行性.
主要方法:
- 在一般ED中接受NMFP-OCT的CRAO/BRAO患者的前性评估.
- 收集关于呈现时间,NMFP-OCT性能时间和诊断结果的数据.
- 基于NMFP-OCT结果的远程诊断和治疗启动.
主要成果:
- 22名CRAO和4名BRAO患者被诊断超过一年.
- 在ED呈现的平均141分钟内进行NMFP-OCT.
- 在4.5小时内进行远程诊断,在2名患者中启用了血栓溶解.
- 在所有情况下,OCT在12小时内都发现了内视网膜超反射/,即使有微妙的 fundus 发现.
结论:
- 在一般ED中实施NMFP-OCT可促进急性RAO的快速远程诊断.
- 这种方法可以迅速启动眼球中风协议.
- 在超急性RAO中,OCT提高了接近正常结尾的诊断准确性,补充了传统的摄影.
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