急性脑梗死静脉溶栓院内绿色通道环节分析

The analysis of green channel link for intravenous thrombolysis in acute cerebral infarction analysis

目的:通过研究发病3h内到达医院就诊的急性脑梗死患者分析如何提高新疆哈密地区静脉溶栓比例。方法:通过回顾性调查,对发病3h内到院的急性脑梗死患者是否选择静脉溶栓治疗的因素统计,并对需要改进的环节进行对策分析。结果:63例缺血性脑卒中患者在发病3h内到达医院就诊,18例接受静脉溶栓治疗,占28.57%,经过统计学分析,其中转运方式、首发主要症状与院前时间与是否溶栓显著相关(P<0.05),早期决策与缩短院内DNT和提高溶栓比例显著相关(P<0.01),因首诊医生和家属对卒中认知不足放弃溶栓比例过高也是关键环节之一。结论:加强社会多方式、多语言和多途径宣教提高公众对脑卒中的认知,加强全员培训优化院内卒中流程,特别是急诊科、门诊和民族医生的培训至关重要,均有助于提高本地区脑梗死溶栓治疗比例。

Objective：To analysis of stroke onset of acute cerebral infarction within 3 h and to improve intravenous thromholysis rate in Haml district, Xinjiang. Method： By retrospective investigation, the incidence of 3 hours to school whether intravenous thrombolytic therapy in acute cerebral infarction patients factors of statistics, and countermeasures for improvement of link analysis. Result： Sixty-three cases of ischemic cerebral apoplexy patients in the three hours to reach the hospital, 18 cases treated with intravenous thrombolysis, accounted for 28.57 %, af- ter statistics analysis, including transport processes, starting main symptoms and pre-hospital time and whether thrombolysis significant correlation （P〈 0. 05）, early decision cases are shortened hospital DNT and improve thrombolysis ratio significant correlation （P〈0. 01）,for the first clinical doctors and relatives is insufficient give up thrombolysis for stroke cognition high proportion is one of the key links. Conclusion： Improve social multimode, multilingual and multi-channel training to improve the public＇s perception of cerebral apoplexy, strengthen employee training process optimization in the stroke, especially in the emergency department, clinic and the doctor＇s training is crucial,help to improve the region cerebral infarction thrombolysis treatment.