脑卒中患者院前救治体会

Experience of prehospital treatment of stroke patients

目的:总结院前脑卒中患者救治方法。方法:回顾性分析淮安市急救中心从2012年1月—2017年4月救治47例脑卒中患者院前临床表现、诊断及救治策略。结果:47例脑卒中患者,脑出血20例;脑梗塞27例,其中脑血栓24例,脑栓塞3例。甘露醇降低颅内压15例,硝普钠、硝酸甘油降压14例,平衡液及多巴胺升压2例,安定控制抽搐4例,口咽通气管2例,球囊面罩辅助通气1例,9例末处理,经现场救治及转运途中无死亡病例。结论:应加强公众或社区医生对脑卒中症状早期识别、早期呼救,120早期电话指导及处理,缩短院前救治时间,合理转运,院前院内无缝连接,对减少脑卒中患者致残率,致死率有重要意义。

Objective To summarize the prehospital treatment methods of stroke patients. Methods The clinical manifestations, diagnosis and treatment of 47 stroke patients in Huaian emergency medical center from January 2012 to April 2017 were analyzed retrospectively. Results Among the 47 strokepatients, brain hemorrhage was 20. There were 27 cerebral infarction, including 24 cerebral thrombosis and 3 cases of cerebral embolism. Mannitol was used to reduce intracranial pressure in 15 patients, Sodium nitroprusside and nitroglycerin lowering blood pressure in 14 cases, 2 cases of equilibrium liquid and dopamine to raise blood pressure, diazepam was used to control convulsions in 4 cases, oropharyngeal airway in 2 cases, 1 case of simple breathing bag connecting mask assisted ventilation, 9 cases untreated, No patient died on the scene and rushed to the hospital. Conclusion We should strengthen public or community doctors for early identification and call for help, 120 telephone guidance and early treatment, shorten the pre-hospital treatment time, reasonable transfer, seamless connection with pre-hospital and nosocomial,Which is important to reduce the morbidity and mortality of stroke patients.