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Neurology：头孢曲松可大幅提高急性脑卒中患者治疗成本效益

2018-04-09 zhangfan MedSci原创

急性脑卒中头孢曲松成本效益
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研究发现，对于急性脑卒中患者预防性头孢曲松护理相比于现行标准护理可大幅降低患者治疗花费，提高质量成本效益

近日研究人员考察了急性脑卒中患者预防性头孢曲松护理与无预防性抗菌药物标准卒中护理的成本效果差异。

2010-14年间2550名急性脑卒中患者参与研究，患者随访3个月，对患者的直接、间接、医疗和非医疗护理费用进行了评估。研究的主要终点是Rankin评分(mRS)以及生活质量调整寿命(QALY)提高1个单位的花费。

2538名患者参与意向分析，2538人参与医院资源利用分析，1453人参与其他资源利用分析。各治疗组机构护理资源的使用、自付费用和生产力损失具有可比性。头孢曲松组平均mRS得分2.38分，对照组为2.44分，头孢曲松组占优但不显著。3个月后头孢曲松组平均QALY得分0.163，对照组为0.155，头孢曲松组表现更佳。头孢曲松组治疗的成本效益范围在0.67-0.89之间，较标准疗法每单位mRS以及QALY得分改善的成本降低2290及12200欧元（p=0.75）。

研究发现，对于急性脑卒中患者预防性头孢曲松护理相比于现行标准护理可大幅降低患者治疗花费，提高质量成本效益。

原始出处：

Willeke F. Westendorp et al. Preventive Antibiotics in Stroke Study (PASS) A cost-effectiveness study. Neurology. April 6，2018.

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    2018-12-21 wangyang7969

    #卒中患者#

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    2018-05-05 weihongyv

    #脑卒中患者#

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    2019-01-25 heli0118

    #治疗成本#

    0

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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304265, encodeId=bd24304265d8, content=谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c9352223976, createdName=1210beb0m21暂无昵称, createdTime=Mon Apr 09 19:37:48 CST 2018, time=2018-04-09, status=1, ipAttribution=)]
    2018-05-18 yinhl1978

    #Neurol#

    0

  5. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304265, encodeId=bd24304265d8, content=谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c9352223976, createdName=1210beb0m21暂无昵称, createdTime=Mon Apr 09 19:37:48 CST 2018, time=2018-04-09, status=1, ipAttribution=)]
    2018-04-11 zhaojie88

    #成本效益#

    0

  6. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304265, encodeId=bd24304265d8, content=谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c9352223976, createdName=1210beb0m21暂无昵称, createdTime=Mon Apr 09 19:37:48 CST 2018, time=2018-04-09, status=1, ipAttribution=)]
    2018-04-11 songbq

    #急性脑卒中#

    0

  7. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304265, encodeId=bd24304265d8, content=谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c9352223976, createdName=1210beb0m21暂无昵称, createdTime=Mon Apr 09 19:37:48 CST 2018, time=2018-04-09, status=1, ipAttribution=)]
    2018-04-11 yhj-time

    #头孢曲松#

    0

  8. 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ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=304265, encodeId=bd24304265d8, content=谢谢!, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=c9352223976, createdName=1210beb0m21暂无昵称, createdTime=Mon Apr 09 19:37:48 CST 2018, time=2018-04-09, status=1, ipAttribution=)]
    2018-04-11 仁医06

    #头孢#

    0

  9. 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    2018-04-10 wzb521zf

    一起学习学习

    0

  10. 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    2018-04-09 1210beb0m21暂无昵称

    谢谢!

    0

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由此可见，急性卒中后接受DET的患者与单纯NGT患者相比，出院时残疾更为严重，并伴有较高的住院率、医疗并发症和长期死亡率。

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科学的多模态影像学检查，包括CTA和CTP，能够提过颅内血管和颅脑灌注情况并能够区分梗死核心和半暗带，从而对静脉溶栓患者的选择提供了可靠科学的信息。本研究提出假说：多模态影像学技术能够增加静脉溶栓的数量并改善治疗预后，并将实验结果发表在Int J Stroke上。

Radiology：真真假假是否能看透--CTA在鉴别真假颈内动脉闭塞的能力有多大？

本研究旨在评价CTA在鉴别真假颈部颈内动脉（ICA）闭塞的准确性及稳定性，并将结果发表在Radiology上。