臺灣榮總腦中風實作指引（TW VGH Stroke IG）
0.1.0 - ci-build
臺灣榮總腦中風實作指引（TW VGH Stroke IG）, published by 高雄榮民總醫院 (VGHKS). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/SitatechCo/TWVGHStroke_IG_Build/ and changes regularly. See the Directory of published versions
| Draft as of 2026-10-07 |
{
"resourceType" : "ValueSet",
"id" : "stroke-care-process-code",
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet stroke-care-process-code</b></p><a name=\"stroke-care-process-code\"> </a><a name=\"hcstroke-care-process-code\"> </a><ul><li>Include these codes as defined in <a href=\"CodeSystem-stroke-observation.html\"><code>http://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation</code></a><span title=\"Version is not explicitly stated, which means it is fixed to the version provided in this specification\"> version 📦0.1.0</span><table class=\"none\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-no-pre-admission-medication\">no-pre-admission-medication</a></td><td style=\"color: #cccccc\">住院前無用藥</td><td>住院前是否未用任何登錄藥物類別。valueBoolean：true＝是，false＝否。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-icu-admission\">icu-admission</a></td><td style=\"color: #cccccc\">入住加護病房</td><td>住院期間是否入住加護病房（ICU）。valueBoolean：true＝有，false＝沒有。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-first-ct-mri-from-outside-hospital\">first-ct-mri-from-outside-hospital</a></td><td style=\"color: #cccccc\">首次 CT／MRI 為外院影像</td><td>第一次 CT 或 MRI 是否在外院完成。valueBoolean：true＝是，false＝否。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-main-reason\">ivtpa-not-given-main-reason</a></td><td style=\"color: #cccccc\">未施打 IV-tPA 主要原因</td><td>未施打靜脈血栓溶解劑（IV-tPA）的主因。valueCodeableConcept：REA01＝發作超過 3 小時或發作時間不明，REA02＝發作至到院 2 小時內但不符合施打條件，REA03＝發作至到院 2 至 3 小時內但不符合施打條件。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-onset-over-3h\">ivtpa-not-given-onset-over-3h</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：發作超過 3 小時</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：給藥前缺血性中風發作超過 3 小時。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-mild-or-improving\">ivtpa-not-given-mild-or-improving</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：症狀輕微或快速改善</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：給藥前症狀快速改善或輕微（例如 NIHSS < 4）。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-severe-stroke\">ivtpa-not-given-severe-stroke</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：嚴重中風</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：臨床或影像判定為嚴重中風（例如 NIHSS > 25）。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-age-out-of-range\">ivtpa-not-given-age-out-of-range</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：年齡不符</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：年齡 18 歲以下或 80 歲以上。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-prior-stroke-with-diabetes\">ivtpa-not-given-prior-stroke-with-diabetes</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：曾中風合併糖尿病</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：曾中風且合併糖尿病。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-high-blood-pressure\">ivtpa-not-given-high-blood-pressure</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：血壓過高</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：收縮壓 > 185 mmHg 或舒張壓 > 110 mmHg。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-recent-stroke-or-head-trauma\">ivtpa-not-given-recent-stroke-or-head-trauma</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：近期中風或頭部外傷</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：近 3 個月內曾中風或嚴重頭部外傷。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-seizure-at-onset\">ivtpa-not-given-seizure-at-onset</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：發作時併發癲癇</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：中風發作時併發癲癇。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-oral-anticoagulant\">ivtpa-not-given-oral-anticoagulant</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：正使用口服抗凝血劑</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：正使用口服抗凝血劑（例如 warfarin，INR > 1.3）。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-ivtpa-not-given-family-refusal\">ivtpa-not-given-family-refusal</a></td><td style=\"color: #cccccc\">未施打 IV-tPA：家屬拒絕</td><td>未施打靜脈血栓溶解劑（IV-tPA）的原因之一：家屬拒絕。valueBoolean：true＝有此原因，false＝沒有此原因。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-no-antithrombotic-within-24h\">no-antithrombotic-within-24h</a></td><td style=\"color: #cccccc\">EVT 後 24 小時內未用抗血栓藥</td><td>EVT 後 24 小時內未用抗血栓藥物。勾選時填 valueBoolean = true；未勾選不建立此項。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-no-surgery\">no-surgery</a></td><td style=\"color: #cccccc\">無手術治療</td><td>住院期間未接受手術治療。勾選時填 valueBoolean = true；未勾選不建立此項。</td></tr><tr><td><a href=\"CodeSystem-stroke-observation.html#stroke-observation-no-discharge-medication\">no-discharge-medication</a></td><td style=\"color: #cccccc\">離院時無用藥</td><td>離院時是否未用任何登錄藥物類別。valueBoolean：true＝是，false＝否。</td></tr></table></li></ul></div>"
},
"url" : "http://vgh-stroke-ig.fhir.tw/ValueSet/stroke-care-process-code",
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.25.302850195961256199157984928504746628194"
}
],
"version" : "0.1.0",
"name" : "StrokeCareProcessCodeVS",
"title" : "腦中風－照護流程紀錄項目值集",
"status" : "draft",
"experimental" : false,
"date" : "2026-10-07T16:40:32+00:00",
"publisher" : "高雄榮民總醫院 (VGHKS)",
"contact" : [
{
"name" : "高雄榮民總醫院 (VGHKS)",
"telecom" : [
{
"system" : "url",
"value" : "https://www.vghks.gov.tw/"
}
]
}
],
"description" : "此 ValueSet 列出「腦中風－照護流程紀錄」（StrokeCareProcess）Observation.code 可用的項目代碼，包括未施打 IV-tPA 的原因、首次影像是否為外院影像、入住加護病房，以及各項「無用藥」「無手術」註記。共 17 個代碼，皆來自 StrokeObservationCS。",
"compose" : {
"include" : [
{
"system" : "http://vgh-stroke-ig.fhir.tw/CodeSystem/stroke-observation",
"concept" : [
{
"code" : "no-pre-admission-medication"
},
{
"code" : "icu-admission"
},
{
"code" : "first-ct-mri-from-outside-hospital"
},
{
"code" : "ivtpa-not-given-main-reason"
},
{
"code" : "ivtpa-not-given-onset-over-3h"
},
{
"code" : "ivtpa-not-given-mild-or-improving"
},
{
"code" : "ivtpa-not-given-severe-stroke"
},
{
"code" : "ivtpa-not-given-age-out-of-range"
},
{
"code" : "ivtpa-not-given-prior-stroke-with-diabetes"
},
{
"code" : "ivtpa-not-given-high-blood-pressure"
},
{
"code" : "ivtpa-not-given-recent-stroke-or-head-trauma"
},
{
"code" : "ivtpa-not-given-seizure-at-onset"
},
{
"code" : "ivtpa-not-given-oral-anticoagulant"
},
{
"code" : "ivtpa-not-given-family-refusal"
},
{
"code" : "no-antithrombotic-within-24h"
},
{
"code" : "no-surgery"
},
{
"code" : "no-discharge-medication"
}
]
}
]
}
}