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在美国,所有急性中风病人常规住医院治疗,英国则不然,20％—60％首次中风患者是不住院治疗的。为了探讨这方面的争议,作者对该急诊科(ED)一年内诊断为缺血性中风、TIA或出血性中风的病人进行回顾性研究。 该组病例男87名,女81名,年龄20～90岁,平均56岁。ED诊断为缺血性中风129例,TIA22例,出血性中风26例。其中161例收入院治疗,无神经缺失症状21例,有神经缺失症状140例。出院时症状改善83例,未改善43例,病情恶化13例,死亡1例。有27例出院诊断与ED诊断不同。10％的病人,ED诊断为缺血性中风,而出院时既未发现中风,也未发现TIA。还有17例在ED时对于是否需要住院
In the United States, all acute stroke patients are routinely hospitalized, while in the United Kingdom, 20% to 60% of first stroke victims are not hospitalized. To address this controversy, the authors conducted a retrospective study of patients diagnosed with ischemic stroke, TIA, or hemorrhagic stroke within one year of the ED. The group of 87 males and 81 females, aged 20 to 90 years, mean 56 years. ED was diagnosed as ischemic stroke in 129 cases, TIA in 22 cases, hemorrhagic stroke in 26 cases. Among them, 161 cases were hospitalized, 21 cases had no nerve loss symptoms, and 140 cases had nerve loss symptoms. At discharge, symptoms improved 83 cases, 43 cases did not improve, 13 cases of deterioration, 1 case of death. There are 27 cases of discharge diagnosis and ED diagnosis is different. In 10% of patients, ED was diagnosed as ischemic stroke and neither discharge nor TIA was found at discharge. There are still 17 cases in the ED for the need for hospitalization