Suchergebnisse

Zhuo Liu,1,2 Dandan Liu,3 Zhen-Ni Guo,2 Hang Jin,2 Tong Sun,4 Chunping Ni,1,* Xiuli Yan2,* 1Fourth Military Medical University, School of Nursing, Xi'an, People's Republic of China; 2Department of Neurology, The First Hospital of Jilin University, Changchun, People's Republic of China; 3Physical Examination Center, The First Hospital of Jilin University, Changchun, People's Republic of China; 4Cadre Ward, The First Hospital of Jilin University, Changchun, People's Republic of China*These authors contributed equally to this workCorrespondence: Xiuli YanDepartment of Neurology, the First Hospital of Jilin University, 71# Xinmin Street, Changchun, 130021, People's Republic of ChinaTel +86-15843079660Fax +86-431-88782378Email yanxiuli2008@126.comChunping NiFourth Military Medical University, School of Nursing, 169# Changle Road West, Xi'an, 710032, People's Republic of ChinaTel +86-13572498128Fax +86-29-84711715Email pingchunni@163.comBackground: Deep vein thrombosis (DVT) is common among patients with stroke. However, the incidence of DVT in acute ischemic stroke patients treated with thrombolytic therapy and the risk factors associated with this condition are unknown.Objective: This study aimed to investigate the incidence and risk factors of DVT after thrombolysis in patients with acute ischemic stroke.Settings and Methods: We retrospectively reviewed the medical records of all patients with acute ischemic stroke who underwent ultrasonic examination after intravenous thrombolysis between April 2017 and December 2019 at the stroke center of the First Hospital of Jilin University, China. Color duplex ultrasound was used to diagnosis DVT in all patients within 72 h after intravenous thrombolysis. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for DVT.Results: Overall, 474 patients were included in the study. Of these, 75 (15.8%) developed DVT (95% confidence interval 12.5– 19.1). Older age was the risk factor that most significantly affected the development of DVT (p = 0.001). Compared to patients younger than 60 years old, those aged 60– 69 years and ≥ 70 years had a higher risk of DVT, at rates of 2.201 (95% CI: 1.033– 4.689; p < 0.05) and 4.241 (95% CI: 2.016– 8.922; p < 0.001) times higher, respectively. Patients with higher triglyceride levels (odds ratio 0.545, 95% CI: 0.372– 0.799, p = 0.002) and longer activated partial thromboplastin time (OR 0.927, 95% CI: 0.862– 0.996, p = 0.040) were less likely to have DVT.Conclusion: DVT is a common complication among patients undergoing intravenous thrombolysis after acute ischemic stroke. Advanced age may increase the occurrence of DVT to some extent. For these patients, safe antiplatelet therapy should be explored and implemented as soon as possible.Keywords: acute ischemic stroke, deep vein thrombosis, incidence, risk factors, thrombolytic therapy

Background: From 2017, the Stroke Health Manager Training Project was carried out by the Chinese Government to strengthen health management and follow-up intervention after ischemic stroke. The aim of this study was to investigate whether after the intervention of the stroke health manager, the control of blood pressure, low-density lipoprotein cholesterol (LDL-C), glucose level, and the use of secondary prevention medications improved 3 months after discharge from our center following ischemic stroke. Methods: The study used a history-controlled approach. Patients who received stroke health manager intervention from May 1, 2018, to March 31, 2019, were considered as the intervention group; those from May 1, 2017, to April 30, 2018, were enrolled as the control group. Stroke health manager intervention included health education, discharge advice, online WeChat public group follow-up, and clinical consultation. Results: In total, 642 patients with ischemic stroke were enrolled in this study (277 in the control group, 365 in the intervention group). At 3 months, the blood pressure, LDL-C and glucose control in the intervention group were better than in the control group (all P < 0.05). At the same time, the overall persistence for secondary prevention medications at 3 months after discharge increased from 201/277 (72.56%) to 303/365 (83.01%, P = 0.001). The persistence for patients taking antiplatelet, hypoglycemic and statins were significantly higher in the intervention group (P < 0.05). Conclusions: Stroke health manager intervention improved the control of blood pressure, LDL-C, glucose levels and the persistence for secondary prevention medications 3 months after discharge.