缩短院内延迟在缺血性脑卒中静脉溶栓治疗中的临床价值研究

Clinic value of reducing in-hospital delay in patients with acute ischemic stroke after intravenous thrombolysis

目的：探讨通过卒中绿色通道建立,缩短院内延迟在急性脑梗死静脉溶栓治疗中的临床价值。方法收集2012年9月~2013年8月本科51例急性脑梗死患者接诊后进入卒中绿色通道,在4.5 h内接受重组组织型纤溶酶原激活物（rt-PA）静脉溶栓的急性脑梗死患者,评价就诊至溶栓时间,溶栓前、溶栓后2 h、14 d NIHSS 评分,溶栓后90 d mRS 评分,并分析危险因素与静脉溶栓预后的相关性。结果51例急性脑梗死患者从接诊至溶栓治疗的平均时间为（62.6±11.7）min,60 min 内接受溶栓治疗24例（47%）,44例完全或部分好转出院,院内延迟时间（DNT）〈62.6 min 组和〉62.6 min 组的 NIHSS 和 mRS 评分的差异明显（P 〈0.05）,即 DNT≤62.6 min 组预后较好。结论卒中绿色通道建立可有效缩短院内延迟时间,增加急性脑梗死患者溶栓治疗机会,具有较高的临床应用价值。

Objective To explore the clinical value of reducing in-hospital delay in patients with acute is-chemic stroke after intravenous thrombolysis across establishing green channel.Methods 5 1 patients with a-cute ischemic strokes treated by recombinant tissue-type plasminogen activator within 4.5 h from symptoms onset were enrolled in this study.The door-to-needle time （DNT）,the National Institute of Health Stroke Scale （NIHSS）score at before thrombolysis therapy,2 h and 7 d after thrombolysis therapy were evaluated.Modified Rankin Scale score（mRS）were evaluated after 30 days.Investigating factors and favorable outcome.Results The median time of DNT was reduced to 62.6 1 1 .7 minutes in 5 1 patients.Proportion of patients presenting ≤60 minutes approved Intravenous thrombolysis was 47%.Hyptension is significantly associated with unfavor-able outcome.Conclusions By establishing green channel,reducing in-hospital delay can provide an opportunity to patients with acute ischemic stroke.