急诊绿色通道的优化在急性缺血性脑卒中静脉溶栓治疗中的应用价值

Application value of emergency green channel optimization in the treatment of intravenous thrombolysis for patients with acute ischemic stroke

目的探讨急诊绿色通道的优化在急性缺血性脑卒中(AIS)静脉溶栓治疗中的应用价值。方法选取2014年1月—2017年12月惠州市第一人民医院脑卒中绿色通道收治的使用阿替普酶(rtPA)静脉溶栓的AIS患者64例,其中将优化前(2014年1月-2016年6月)的30例就诊患者设为对照组,流程优化后(2016年7月—2017年12月)就诊的34例患者设为优化组。比较两组患者从急诊就诊到做CT时间、就诊到化验结果出来时间、就诊到神经科会诊时间、就诊到静脉溶栓时间(DNT)、rt-PA治疗前后NIHSS评分。结果两组患者从急诊就诊到做CT时间、就诊到化验结果出来时间、就诊到神经科会诊时间及DNT相比较,优化组均短于对照组,差异有统计学意义(P<0.05);两组患者在脑出血转化率、死亡率进行比较,两组间差异无统计学意义(P>0.05);优化组患者治疗后NIHSS评分低于对照组,差异有统计学意义(P<0.05)。结论急诊绿色通道流程的优化可以缩短急性缺血性脑卒中DNT,改善溶栓患者的预后。

Objective To investigate the application value of strengthening the emergency green channel in the treatment of intravenous thrombolysis for patients with acute ischemic stroke.Methods A total of 64 patients diagnosed acute ischemic stroke（AIS） were selected,they were given recombinant human tissue plasminogen activator（rt-PA） for the treatment of intravenous thrombolysis during January 2014 and December2017.30 patients in control group（they got therapy from January 2014 to June 2016）,34 patients in optimization group（they got treatment from July 2016 to December 2017）.Time from visiting the hospital to carry out CT examination,time from visiting the hospital to acquiring test report,time from visiting the hospital to consultation,door-to-needle time（DNT）,and NIHSS score before and after the application of rt-PA of both groups were compared.Results The time from visiting the hospital to carry out CT examination,time from visiting the hospital to acquiring test report,time from visiting the hospital to consultation,door-to-needle time in the optimization group were shorter than the control group,the differences between the two groups were statistically significant（P〈0.05）.The differences of hemorrhagic transformation and mortality after rt-PA treatment between the two groups were not statistical significant（P〈0.05）.Comparing NIHSS after rt-PA treatment of two groups,difference was statistically significant（P〈0.05）.Conclusions The optimization of the emergency green channel can shorten the DNT of patients with AIS and improve the prognosis.