医療過疎地域での遠隔診療支援システムを用いた脳梗塞急性期医療

Introduction : The validity of intravenous rt-PA therapy for acute ischemic stroke patients within ４．５ hours after onset is reported, but the rate of the delivery of rt-PA therapy is assumed lower due to its lack of stroke specialists and its geographic location in depopulated areas. In February ２０１３, we developed the telemedicine system in our medically under-served area as a potential solution of medical disparities. Objects and Methods : After the introduction for １６ months, ９５ acute ischemic stroke patients were transferred to our hospital, seven （７．３７％） of which were subjected to the “drip and ship” method of rt-PA infusion using a telemedicine system for emergency medicine （k-support）. We examined the time course after onset and the treatment outcome of these seven cases. Results : Seven cases had rt-PA infusion started in the depopulated area. In five cases, recanalization of occluded vessels were demonstrated resulting in improved clinical symptoms. Conclusion : It was able to give a standard therapy using rt-PA infusion for acute ischemic stroke and the quality of the cerebral infarction medical treatment was improved by building the telemedicine system in the depopulated area.