团队工作模式在急诊静脉溶栓的急性缺血性脑卒中患者中的应用价值

The clinical value of teamwork pattern in acute ischemic stroke patients treated with intravenous thrombolysis

目的探讨团队工作模式在抢救急性缺血性脑卒中(acute isehemic stroke,AIS)静脉溶栓患者中的临床价值。方法连续性选择2015年1月-2016年12月在上海市嘉定区中心医院就诊并行静脉溶栓治疗的AIS患者126例,以建设卒中中心的时间节点分为对照组和研究组,分别采用传统救治流程和团队工作模式救治流程,比较两组患者的一般人口学资料、基线临床资料、急诊处置效能(包括就诊至CT检查时间、就诊至CT报告时间、就诊至血常规报告时间、CT报告至静脉溶栓时间、就诊至静脉溶栓时间、60min内溶栓率)、院内情况(治愈率、好转率、未治愈率、死亡率、住院天数)和治疗总体满意度。结果在基线一致的前提下,相对于对照组,研究组就诊至CT检查时间、就诊至CT报告时间、就诊至血常规报告时间、CT报告至静脉溶栓时间、就诊至静脉溶栓时间显著缩短,60min内溶栓率显著提高(P<0.05);治疗效果明显提高(P<0.05);住院天数缩短(P<0.05);急诊处理的总体满意度提高(P<0.05)。结论团队工作模式能提高急诊处置效能,减少患者住院天数,提高患者的治疗效果及治疗总体满意度。

Objective To evaluate the clinical value of teamwork pattern in acute ischemie stroke patients (AIS)treated with intravenous thrombolysis (IVT).Methods From January 2015 to December 2016,a total of 126AIS patients with IVT were enrolled the study.The patients were divided into control group and research group by using the different years.The general demographic data,baseline clinical data,emergency disposal efficiency (including visits to CT examination time,clinic and CT report time,visits to the blood routine report time,CT to intravenous thrombolysis time, visits to intravenous thrombolysis time,thrombolysis rate within 60 min),in the situation (cure rate,rate of improvement,untreated rate,mortality,and hospitalization days)and overall satisfaction with treatment were compared. Results Based on the identical baseline,compared with the control group,the effectiveness of emergency treatment, IVT in 60mins,and the overall satisfaction were significantly improved.Meanwhile,treatment effect was also improved, the hospitalization days were Significantly shortened and the degree of satisfation was improved.(all P <0.05). Conclusion The teamwork pattern can improved the effectiveness of emergency treatment,IVT in 60mins,treatment effect and the overall satisfaction.