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ANALIZA INTERVALULUI DINTRE DEBUTUL I INTERNAREA BOLNAVILOR CU STROKE ACUT M. PEREANU, C.

MUTU Secia clinic de Neurologie, Spitalul Clinic Judeean Sibiu Obiectiv: Analizarea intervalului dintre debutul primelor simptome clinice, internarea bolnavilor cu stroke acut i efectuarea CT cranian. Metod: n acest studiu prospectiv au fost luai n eviden un numr de 240 de bolnavi (119 femei i 121 brbai, cu vrsta medie de 67,4 ani) cu stroke acut internai consecutiv n perioada 01.11.2003-28.02.2004. Datele au fost culese prin anamnez de la bolnavi i/sau aparintorii acestora i au fost consemnate n foaia de observaie clinic. Rezultate: n primele 24 de ore de la debutul simptomelor au fost internai un numr de 183 (85,12%) de bolnavi. Dintre acetia 61 (25,75%) au fost spitalizai n primele 3 ore, iar 105 (43,75%) n primele 6 ore de la debutul primelor simptome i semne clinice. CT cranian a fost efectuat n total la 108 (70,42%) bolnavi, n aceeai zi cu internarea la 36 (15%). Media zilelor de la spitalizare pn la efectuarea CT cranian a fost de 5. n funcie de tipul de stroke la internare, ischemii cerebrale au prezentat 198 (82,5%) dintre pacieni, hemoragii cerebrale fiind prezente la 39 (16,23%) iar hemoragii subarahnoidiene la 3 (1,25%). Dintre pacienii internai n primele 3 ore, ischemiile cerebrale au fost prezente la 47 (77%) pacieni reprezentnd 23,75% din totalul ischemiilor spitalizate. Dup modul de sosire, 175 (73%) de bolnavi au fost adui cu ambulana, 65 (27%) cu mijloace proprii. Concluzii: Aproximativ un sfert dintre pacienii cu ischemie cerebral au fost internai n fereastra terapeutic util pentru administrarea de medicamente trombolitice (3 ore). Surprinde ns numrul mic de CT craniene efectuate n ziua internrii precum i media mare a intervalului de la internare pn la efectuarea CT. ANALYSIS OF TIME INTERVAL BETWEEN THE ONSET OF CLINICAL SYMPTOMS AND HOSPITAL ADMISSION OF PATIENT WITH ACUTE STROKE M. PEREANU, C. MUTU Clinical Department of Neurology, Clinical County Hospital of Sibiu Objective: Analysis of time interval (gap) between the onset of clinical symptoms and hospital admission of patients suffering an acute stroke on one side and CT scan performing on the other. Method: This was a prospective study made on of 240 patients (of which 119 were female and 112 male, the average age being 67,4 y) suffering an acute stroke and being hospitalized during 01.11.2003-28.02.2004 interval. The dates were traced through histories only as it was recorded by clinic papers. Results: A number of 183 (85,12%) patients were hospitalized within the first 24 hours from the onset of symptoms. Of these, 61 (25,75%) patients came within the first 3 hours and 105 (43,75%) patients within the first 6 hours. CT scan was performed in 168 (70,42%) patients during the first hospitalization day. A total of 168 (70,42%) patients having had a CT scan at some point during the hospital stay. The average number of days passed until CT scan was done was 5. By the etiology, there were 198 (82,5%) patients with brain infarction, 39 (16,23%) with intracerebral hemorrhage and 3 (1,25%) with subarachnoid hemorrhage. A number of 47 (77%) of those who were admitted within the first 3 hours (from the onset of clinical symptoms) had presented with brain ischaemia, representing 23,75% of all ischaemic strokes. By the arrival procedure, 175 (73%) of patients were transported by ambulance (used the ambulance service) and 65 (21%) by other means (e.g. using private cars). Conclusions: Roughly, 25% of all patients with ischaemic stroke were admitted within the useful therapeutic window (interval) for thrombolytic treatment (i.e. 3 hours regarding the efficacity of thrombolytic medication). Note the reduced number of CT scan performed during the whole hospital admission day as well as the increased (i.e. 5) number of days (average) from the onset of symptoms till a CT scan was done.