Objective To assess the clinical efficacy of stroke unit (SU) of integrated traditional Chinese medicine and western medicine in the treatment of acute cerebral stroke. Methods Randomized or quasi-randomized controlled trials (RCTs or q-RCTs) were identified from CBM (1978-2009), CNKI (1994-2009), VIP (1989-2009), PubMed (1966-2009), MEDLINE (1978-2009), Scifinder (1998-2009), and The Cochrane Library (Issue 6, 2009), and relevant journals from Liaoning University of Traditional Chinese Medicine were also hand searched. Data were extracted and evaluated by two reviewers independently with a designed extraction form. RevMan5.0.23 software was used for data analyses. Results A total of 12 RCTs and q-RCTs involving 2 316 patients were included. Meta-analyses showed that, stroke unit of integrated traditional Chinese medicine and western medicine was superior to general medicine treatment (Plt;0.05) in case fatality rate one month after stroke (RR= 0.34, 95%CI 0.22 to 0.54), discharge NIHSS score (WMD= –1.01, 95%CI –1.52 to –0.51) and discharge OHS score (WMD= –0.48, 95%CI –0.78 to –0.18); and it was superior to SU of western medicine (Plt;0.05) in NIHSS score one week after stroke (WMD= –2.38, 95%CI –4.08 to –0.68), NIHSS score one month after stroke (WMD= –1.52, 95%CI –2.32 to –0.73) NIHSS score three months after stroke (WMD= –1.77, 95%CI –2.59 to –0.95), difference value of NIHSS score of hospital admission and discharge (WMD= –1.94, 95%CI –2.54 to –1.34), OHS score one month after stroke (WMD= –0.56, 95%CI –0.95 to –0.17) and OHS score three months after stroke (WMD= –1.05, 95%CI –1.44 to –0.66). Conclusion The current limited evidence shows that there is a significant difference between stroke unit of integrated traditional Chinese medicine and western medicine and general medicine treatment. Although there is no significant difference compared with SU of western medicine, it is superior in improving the functional impairment of nerve as well as disability of injury. More large-scale RCTs with high quality are required to verify the effect of stroke unit of integrated traditional Chinese medicine and western medicine in the treatment of acute cerebral stroke.
A stroke unit means organized inpatient stroke care. The available evidence shows that stroke unit is the most effective treatmeat in stroke care. The definition, classification and the essential components of stroke unit have been explained in this article to help better understanding on it.
Objective We aimed to evaluate the current status of the construction and practice of the stroke center in West China Hospital of Sichuan University and develope a future strategy to promote the standardized developement of inpatients care and evidence practice. Methods The current status of the Stroke Center in West China Hospital of Sichuan University was assessed. The procedure of diagnosis and treatment was inspected in detail, including triage, thrombolytic therapy, antithrombotic medication and anticoagulant, primary and secondary prevention, filter of risk factors, rehabilitation and education for patients. After that, new plans were made on the basis of the assessment and experiences acquired from practices in the Stroke Center in West China Hospital. Results The primary Stroke Center had been constructed in West China Hospital. The practice in West China Hospital showed that the Stroke Center significantly reduced the mortality and shortened the length of hospital stay of the patients with stroke. Conclusion It is proved that construction and implementation of the Stroke Center in West China Hospital are feasible.
目的 探讨联合脑卒中单元在老年脑卒中患者中应用研究。 方法 选择2003年7月－2011年7月在我院住院的60岁以上的260例急性脑卒中患者，随机分为联合脑卒中单元组和普通病房治疗组各130例，两组均采用常规内科或手术治疗，联合脑卒中单元组除常规内科或手术治疗外，入院后病情平稳24～48 h后偏瘫患者给予运动康复训练，吞咽障碍患者给予吞咽康复训练，抑郁患者给予心理康复治疗3个月。对联合脑卒中单元/普通病房治疗两组患者在治疗前及治疗后分别采用改良的巴氏指数测定日常生活能力和汉密顿抑郁量表评分，并进行统计学分析。 结果 联合脑卒中单元组改良的巴氏指数测定日常生活能力、汉密顿抑郁量表评分均有明显改善，与普通病房治疗组比较，差异有统计学意义（P＜0.05）。 结论 联合脑卒中单元对老年脑卒中后偏瘫、吞咽障碍、抑郁患者有明显的干预作用，治疗效果优于普通病房治疗组。
目的 观察对比卒中单元早期康复护理对卒中偏瘫患者肢体功能恢复的效果。 方法 将2011年6月－12月期间住院的脑卒中偏瘫患者88例，按照发病时间分为试验组和对照组，发病5 d以内急性期入院者为试验组，5 d以上入院的超过急性期者为对照组。在规范治疗基础上予以相同的康复护理干预，对其日常生活活动能力采用改良的Rakin量表MRS评分来进行功能评定。 结果 试验组和对照组生活能自理人数分别占25%、13.6%，能部分自理的人数分别占56.8%、40.9%，试验组肢体功能恢复明显高于对照组（P＜0.05）。 结论 卒中单元早期康复护理对脑卒中偏瘫患者肢体功能恢复有重要意义。
【摘要】 目的 探讨在基层医院建立脑卒中单元模式的临床意义。 方法 将2006年1-3月和2007年同期共381例脑卒中患者分为脑卒中单元组和普通病房组。脑卒中单元组按照脑卒中单元模式进行治疗，普通病房组按照传统方法治疗，分别于治疗前、治疗后7、15、30 d时，对比分析两组患者神经功能缺损及疗效。 结果 脑卒中单元组和普通病房组治疗后，随时间两组的神经功能缺损评分（NIHSS）均逐渐降低，两组在治疗后15、30 d时差异有统计学意义（P=0.007），脑卒中单元组家属满意度明显高于普通病房组（P=0.002）。 结论 在基层医院脑卒中单元模式对脑卒中患者的治疗效果明显优于传统治疗。【Abstract】 Objective To investigate the clinical significance of setting up stroke unit model in basic hospital. Methods Three hundreds and eighty-one stroke patients were randomly divided into stroke unit group (n=186) and general ward group (n=189). The stroke unit group patients were treated with the stroke unit model designed by ourselves, while the control group patients were treated with traditional method, The clinical efficacy was compared before treatment, seven days, 15 days and 30 days after treatment. Results Improvement in neurological score was significantly better among patients treated in the SU than in the GW. NIHSS scores gradually reduce in the both groups after treatment, which were significantly lower than those in the control group on 15 days and 30 days after treatment(P=0.007,0.004). The satisfactory of relatives in the stroke unit group was better than that in the general ward group(P=0.002). Conclusion The efficacy of treatment with stroke unit model was better than that of treatment with traditional method in the stroke patients.
ObjectiveTo explore the clinical application of comprehensive stroke units in treating patients of hemorrhagic stroke after craniotomy. MethodsWe randomly divided the 288 postoperative patients with hemorrhagic stroke treated from January 2010 to December 2013 into two groups:stroke unit group and conventional treatment group. Then we observed and compared their clinical indicators after they received different therapeutic regimens. ResultsDifferences in the national Institude of Health Stroke Scale (4.6±3.2 vs. 7.3±4.1), activities of daily living (89.3±15.6 vs. 72.5±20.3), and duration of hospital stays[(23.3±5.2) vs. (32.5±8.3) days] were significant (P<0.05) on discharge day. The infection rate during hospitalization, the scores of Glasgow outcome scale three months after leaving hospital between the stroke unit group and the conventional treatment group were statistically significant (P<0.05). There was no remarkable difference in the average cost of hospitalization between the two groups (P>0.05). ConclusionComprehensive stroke unit treatment can significantly reduce the disability rate for postoperative patients with hemorrhagic stroke, shorten the average length of stay at the hospital, save the health care resources, and improve the patients' ability to return to society as well as the satisfaction of family members.