院内急性缺血性脑卒中的诊治进展

Progress of In-hospital Acute Ischemic Stroke

院内急性缺血性脑卒中(IHAIS)是全部AIS的重要组成部分。IHAIS与院外AIS(OHAIS)在发病机制、病情严重程度以及预后方面皆有明显差异。IHAIS患者较OHAIS患者神经功能缺损更严重,这导致IHAIS患者住院时间更长,住院期间病死率更高,住院期间发生的脑梗死并发症更多,出院时神经功能预后更差以及出院后继续进行康复治疗的患者比例更高。脑卒中合并症、代谢性疾病和血液病、脑卒中严重程度是IHAIS不良预后的主要影响因素,但诊断延迟、转诊延迟、专科评估以及溶栓治疗延误也是IHAIS不良预后的影响因素。

In-hospital acute ischemic strokes （IHAIS） is a significant proportion of all acute isehemic stroke. IHAIS differs from out-of-hospital AIS （OHAIS） in the pathogenesis, disease severity and prognosis, which results in longer hospital stay, higher in-hospital mortality, more in-hospital complications, poorer functional status at discharge,and the increased need for post-discharge rehabilitation care. The co-morbidities, metabolic or hematological derangements and greater stroke severity in IHAIS patients are major contributors to poor outcome, and delays in recognition, referral, specialist assessment and thrombolysis are also important factors for the poor prognosis for IHAIS.