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ID 110387
タイトルヨミ
トクシマ ダイガク ビョウイン ノウソッチュウ センター ニ ハンソウ サレタ rt-PA ジョウチュウ リョウホウ ノ Drip and Ship ショウレイ ニオケル ケントウ
タイトル別表記
“Drip and Ship”Cases of Intravenous rt-PA Therapy Transported to Stroke Care Unit
著者
布村, 俊幸 徳島大学病院卒後臨床研修センター|徳島大学病院脳卒中センター 徳島大学 教育研究者総覧
山上, 圭 徳島大学病院卒後臨床研修センター|徳島大学神経内科
西, 京子 徳島大学病院卒後臨床研修センター|徳島大学脳神経外科 徳島大学 教育研究者総覧 KAKEN研究者をさがす
安積, 麻衣 徳島大学脳神経外科
西山, 徹 徳島大学脳神経外科
吉岡, 正太郎 徳島大学脳神経外科
里見, 淳一郎 徳島大学脳神経外科 KAKEN研究者をさがす
キーワード
Drip and Ship
recombinant tissue-type plasminogen activator
endovascular therapy
資料タイプ
学術雑誌論文
抄録
Recently,“Drip and Ship”treatment conducted in collaboration of a hospital in remote area and an institution capable of emergency stroke treatment under guidance by a stroke specialist has been reported to be effective. “Drip and Ship” treatment refers to initiating intravenous recombinant tissue-type plasminogen activator(rt-PA)infusion at a remote hospital(Drip)and then transporting patients to an institution capable of multimodality management and endovascular treatment of stroke(Ship). We report here a case analysis and examinations on treatment methods, prognosis, and some other parameters in 16 patients who were transported to the Stroke Care Unit(SCU)of the Tokushima University Hospital while undergoing“Drip and Ship”treatment between June 2013 and November 2015. Occluded vessels were recanalized by rt-PA administration in 5/12patients (42%). For 6 cases in which recanalization was not achieved with rt-PA, endovascular treatment was performed, and recanalization was obtained in 3 patients(50%). There was a marked improvement(8.4points on average)in NIHSS at the time of discharge compared to that before rt-PA administration. A representative case showed a 26‐point improvement in NIHSS at the time of discharge compared to the pretreatment value. The advantage of“Drip and Ship”treatment is two-fold : It allows for rt-PA treatment of acute ischemic stroke patients at remote-area institutions incapable of multimodality stroke management, and also makes it possible to add endovascular treatment for rt-PA-irresponsive cases in which recanalization of occluded vessels could not be achieved with rt-PA therapy. The results suggest that the“Drip and Ship”treatment is a safe and effective means to eliminate regional disparities in intravenous rt-PA therapy and can make more contributions to the collaborative stroke care in the Tokushima prefecture in the future.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
72
3-4
開始ページ
107
終了ページ
112
並び順
107
発行日
2016-08-25
EDB ID
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
病院
医学系