摘要
目的观察规范化治疗在缺血性脑卒中(IS)患者二级预防中的应用效果。方法选择2010年7月～2011年7月收治的IS住院患者1 200例,由经过统一培训的神经专科医师在脑卒中信息库中填写一般资料及危险因素等,并随机分为对照组、治疗1组及治疗2组各400例,其中对照组给予常规量的阿司匹林、他汀类等药物治疗;治疗组针对病因及危险因素制定具有针对性的个体化治疗方案,其中治疗1组仅给予健康教育及抗血小板聚集、强化降脂治疗,治疗2组则同时联合颈动脉内膜剥脱术(CEA)或血管成型及支架植入术(CAS)等非药物治疗。随访1 a,观察三组服药依从性及卒中复发率。结果对照组的药物依从性较治疗组明显偏低,治疗1、2组6个月、1 a的复发率明显低于对照组(P均<0.05),治疗2组与治疗1组6个月及1 a的复发率均无明显差异(P均>0.05)。结论对基层医院的IS患者建立简易信息库并进行规范化干预治疗,可明显提高患者服药依从性和降低复发率;逐级建立以基层医院为主导、辐射到社区的全民脑卒中防控体系应成为以后IS防治工作的重点。
Objective To observe the application effect of standardized treatment in the secondary prevention of ische- mic stroke （IS）. Methods A total of 1200 cases of ischemic stroke hospitalized patients from July 2010 to July 2011 were divided into 3 groups, 400 in each ： the control group, the treatment group 1 and treatment group 2. Patients in the control group received routine dose of aspirin, statins and other drugs; patients in the treatment group 1 were given health educa- tion, antiplatelet aggregation and intensive lipid-lowering therapy; patients in treatment group 2 were given the same treat- ment combined with other non-drug therapies such as carotid endarterectomy （CEA）, angioplasty and carotid artery stenting （CAS）. Follow-up 1 a, the medication compliance and stroke recurrence rate were observed. Results The medication compliance in the control group was significantly lower compared with that in the treatment groups, and the recurrence rate in 6-month or 1-year of the treatment groups was significantly lower than that in the control group （ all P 〈 0.05 ）. There was no statistically significant difference between the treatment group 1 and 2 in 6-month or 1-year recurrence rate （ all P 〉 0.05）. Conclusion Establishing the simple information base on IS patients in primary hospital and standardizing the in- tervention treatment can significantly improve the medication compliance of patients and reduce the recurrence rate. The na- tional IS prevention and control system should be established step by step by putting primary hospital as the leading and expanding to the whole community, which also should become the focus of IS prevention and control work.
出处
《山东医药》
CAS
2013年第27期45-47,共3页
Shandong Medical Journal
基金
聊城市卫生局2013年医学科研项目(聊卫医函[2013]3号)
关键词
缺血性脑卒中
规范化治疗
复发
二级预防
ischemic stroke
standardized treatment
recurrence
secondary prevention
