Introduction
"New England Journal of Medicine" once reported that the overall risk of Chinese people suffering from stroke in their lifetime is 39.3%, ranking first in the world and 1.6 times the global risk of stroke.
html On May 7, "New England Journal of Medicine" published A study by Chinese scholars pointed out that for eligible patients with acute ischemic stroke, the clinical benefit of direct intravascular mechanical thrombectomy is not inferior to intravenous thrombolysis + mechanical thrombectomy. This means that some stroke patients who have missed the opportunity for intravenous thrombolysis may still be improved by mechanical thrombectomy. Text丨 Caixin reporter Di Ning
The opportunity to rescue stroke patients is expected to be earlier. On May 7, a study by Chinese scholars published in the New England Journal of Medicine pointed out that for eligible patients with acute ischemic stroke, the clinical benefits of direct intravascular mechanical thrombectomy are not inferior to intravenous thrombolysis + Mechanical thrombectomy. This means that some stroke patients who have missed the opportunity for intravenous thrombolysis may still be improved by mechanical thrombectomy.
The above-mentioned study was led by the team of Liu Jianmin, director of the Neurosurgery Department of Changhai Hospital Affiliated to the Naval Medical University, and was conducted in 41 hospitals with advanced stroke centers in China. A total of 656 patients were included and divided into mechanical (direct) thrombectomy group and Intravenous thrombolysis + mechanical thrombectomy combined treatment group.
"It's like when a water pipe is blocked at home. Do you use a melting agent to clear the pipe first and then dig it out, or do you directly use a hook to pull out the blockage." Liu Jianmin described the study. The results showed that there was no significant difference in the vascular recanalization rate between the direct thrombectomy group and the combined treatment group, while the mortality rate of patients in the former was lower than that in the latter.
"Doctors can choose how to quickly clear the pipeline based on existing conditions. This study provides another possibility and thinking for stroke patients to adopt optimal treatment methods." Liu Jianmin said. Craig Anderson, former chairman of the Asia-Pacific Stroke Organization, said, "This study opens up a new world in the treatment of acute ischemic stroke.
The diagnosis and treatment path is expected to be optimized
Stroke , commonly known as stroke, is an acute cerebral infarction Vascular diseases are divided into hemorrhagic stroke and ischemic stroke. The former is commonly known as cerebral hemorrhage, and the latter is commonly known as cerebral infarction. The latter is more common, accounting for about three-quarters of
stroke mortality and disability rates. They rank first in China. In 2018, the New England Journal of Medicine reported that the overall lifetime risk of stroke in China is as high as 39.3%, ranking first in the world, which is 1.6 times the global risk of stroke, with 350 new stroke patients in China every year. More than 10,000 patients have lost their ability to live and work independently.
The stroke diagnosis and treatment path has undergone several changes. In 1995, the NINDS study of the National Institute of Neurological Disorders and Stroke confirmed that recombinant tissue plasminogen activation. After intravenous thrombolysis (rtPA) is effective, it has become the "gold standard" for stroke treatment. Intravenous thrombolysis involves injecting drugs into the body to promote the dissolution of blood clots. The main drugs include alteplase and tenecteplase. After treatment, mechanical thrombectomy surgery gradually entered clinical practice, and combination therapy was first used in 2015. Five randomized controlled studies represented by MR CLEAN released positive results, confirming that intravascular mechanical thrombectomy was performed on the basis of intravenous thrombolysis ( Surgical intervention) can benefit specific patients with acute ischemic stroke (AIS). Subsequently, international and Chinese guidelines have been revised, and patients with AIS caused by large vessel occlusion within 4.5 hours of onset must be treated first if they meet the guideline conditions. After intravenous thrombolysis, he was transferred to the catheterization laboratory for arterial thrombectomy treatment.
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Wuhan unblocked: Overall, 12 of the 13 medium-risk districts are considered low-risk [2020-04-08]
html At 0:00 on April 8, Wuhan "unblocked" Kaicheng. The day before, Hubei Province updated the city and county epidemic risk level assessment: the province remained free. High-risk cities and counties; Wuhan's urban area as a whole is still at medium risk, but the number of low-risk urban areas has increased by 3.According to expert evaluation organized by the Hubei Provincial Center for Disease Control and Prevention, as of 24:00 on April 6, there are 75 low-risk cities and counties in the province. There is one medium-risk city or county (urban area of Wuhan City), and there are no high-risk cities or counties.Among the 13 urban districts in Wuhan, 12 are low-risk areas ( Xinzhou District, Hannan District, Huangpi District, , Jiangxia District, Caidian District, Dongxihu District, Qingshan District, Hanyang District , Jiangan District , Hongshan District , Jianghan District , Wuchang District ), one medium-risk area ( Qiaokou District ), and no high-risk area.
Compared with the assessment on April 2, the risk level assessment results of cities and counties in the province have not changed. The Hongshan District, Jianghan District, and Wuchang District of Wuhan City have been reduced from medium risk to low risk.
Hubei updates risk level again: Wuhan overall maintains medium risk, and the number of low-risk areas in the city has increased to 7 [2020-03-29]
On March 28, Hubei Province updated its city and county epidemic risk level assessment, and there are no high-risk cities in the province. The county and urban areas of Wuhan remain at medium risk as a whole. According to the risk delineation standards in the Joint Prevention and Control Mechanism of the State Council in response to the new coronavirus infection pneumonia epidemic, "Guiding Opinions on Scientific Prevention and Precision Implementation Strategies for the Prevention and Control of the New Coronavirus Pneumonia Epidemic", after evaluation by experts organized by the Provincial Center for Disease Control and Prevention, as of As of 24:00 on March 27, there were 75 low-risk cities and counties in the province, 1 medium-risk city and county, and no high-risk cities and counties. Among the 13 urban districts in Wuhan, there are 7 low-risk areas, 6 medium-risk areas, and no high-risk areas.
Compared with the data released on March 25, the risk level assessment results of cities and counties in the province have not changed; Hannan District and Qingshan District of Wuhan City have been reduced to low risk, while other districts have not changed.
In addition, the risk level assessment results of 13 urban districts in Wuhan were updated simultaneously. According to the assessment: among the 13 urban districts in Wuhan, there are 7 low-risk areas, namely Xinzhou District, Hannan District, Huangpi District, Jiangxia District, and Caidian District , Dongxihu District, and Qingshan District; there are 6 medium-risk areas, namely Hanyang District, Jiangan District, Qiaokou District, Jianghan District, Hongshan District, and Wuchang District; and 0 high-risk areas.
Wang Longde: The overall diagnosis and treatment level of stroke in China is low [2019-05-23]
“After the launch of the construction of stroke centers in 2015, my country’s stroke prevention and treatment work has advanced rapidly. However, from a national perspective, the overall diagnosis and treatment level of cerebrovascular disease in my country is It is still low, and we need to continue to strengthen the training and promotion of key technologies," Wang Longde, deputy director of the Brain Prevention Committee of the National Health Commission and president of the Chinese Society of Preventive Medicine, said at the imaging forum of the China Stroke Conference held recently.
Stroke, also known as "stroke", is an acute cerebrovascular disease that causes brain tissue damage due to the sudden rupture of blood vessels in the brain or the inability of blood to flow into the brain due to blood vessel obstruction. It is divided into two categories: hemorrhagic stroke and ischemic stroke. kind. At present, stroke is still the leading cause of death and disability among adults in China.
The situation of stroke prevention and treatment in China is not optimistic. In the past 30 years, the domestic incidence rate has continued to rise, while the incidence rate of stroke has been declining in many places around the world. China's national stroke screening data shows that the standardized incidence rate of first stroke among people aged 40-74 in China increased from 189/100,000 in 2002 to 379/100,000 in 2013, an average annual increase of 8.3%. According to the 2016 Global Burden of Disease (GBD) data, the incidence rate of ischemic stroke in China reached 276.75/100,000 people, and the incidence rate of hemorrhagic stroke was 126.34/100,000 people. Figures from the "China Cardiovascular Disease Report 2017" show that the number of stroke patients in China is 13 million.
Editor | Ren Bo
Page | Zhao Jinzhao Zeng Meiya
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