针对急性缺血性中风的内血管治疗 (全球MT接入) 的全球挑战
Ahmed Nasreldein1, Wan Asyraf2, Thanh N Nguyen3
1Department of Neurology, Assiut University, Assiut, Egypt.
概括
全球对急性缺血性中风 (AIS) 的机械血栓切除术 (MT) 的使用情况有很大差异. 关键的挑战包括成本,迟到的呈现,以及训练有素的神经干预专家的短缺,特别是在低收入国家.
科学领域:
- 神经学 神经学
- 干预性神经辐射学
- 全球健康 全球健康
背景情况:
- 机械血栓切除术 (MT) 是急性缺血性中风 (AIS) 与大血管封闭 (LVO) 的关键治疗方法.
- 自2015年以来被确立为标准护理,其全球实施面临重大障碍.
研究的目的:
- 确定和分析阻碍机械血栓切除术 (MT) 的全球实施和可访问性的主要挑战.
主要方法:
- 从2022年12月到2023年3月进行了一项国际在线调查.
- 该调查收集了来自89个国家的526名受访者的MT服务可用性,神经成像协议,选择标准,障碍和培训数据.
主要成果:
- 在MT可用性 (22.1%缺乏服务,8.2%的时间有限) 和神经成像协议 (从NCCT到高级CT/MRI输液) 中存在显著的全球差异.
- 治疗神经干预的常见障碍包括成本,患者迟到出现,以及有限的资格获得神经干预服务.
- 只有59.1%的人报告了结构化的MT培训计划,其中包括缺乏培训师和资金等障碍.
结论:
- 全球MT接入,患者选择和培训的差异需要有针对性的干预措施.
- 财政限制和训练有素的神经干预医生的短缺是主要障碍,特别是在低收入和中等收入国家.
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