网络平台对提高急性缺血性脑卒中患者救治水平的作用研究

Role of network platform in improving treatment level of patients with acute ischemic stroke

目的验证急重症脑血管病救治网络平台对提高急性缺血性脑卒中患者救治水平的作用。方法分析云浮市急重症脑血管病救治网络平台建设前1年(2016年)和建设后2年(2017年、2018年)云浮市人民医院神经内科收治的急性缺血性脑卒中患者的静脉溶栓例数、急诊血管内介入治疗例数、入院至静脉溶栓时间(DNT)的差异,以及2018年同区域内通过网络平台转诊及非网络平台转诊的患者中随机抽取的各60例患者(研究组及对照组)治疗前后美国国立卫生研究院卒中量表(NIHSS)评分的差异。结果2017年、2018年静脉溶栓例数分别为85例、103例,溶栓率分别为9.92%、9.83%,均较2016年(50例、6.97%)明显升高,差异均有统计学意义(P<0.05);2017年、2018年急诊血管内介入治疗例数分别为56例、129例,介入治疗率分别为6.53%、12.31%,均较2016年(44例、6.14%)升高,其中2018年与2016年相比差异有统计学意义(P<0.05);2017年、2018年DNT分别为(82.00±18.75) min、(77.00±32.17) min,均较2016年[(109.00±30.58) min]明显缩短,差异均有统计学意义(P<0.05)。治疗1周后研究组及对照组的NIHSS评分[(4.70±3.64)分、(8.90±5.62)分]均较治疗前[(14.30±6.29)分、(13.60±6.37)分]明显降低,且研究组的NIHSS评分更明显低于对照组,差异均有统计学意义(P<0.05)。结论急重症脑血管病救治网络平台的建设和有效运行是提高急性缺血性脑卒中患者救治水平的有效保障。

ObjectiveTo investigate the role of network platform for treatment and rescue of acute and severe cerebrovascular diseases in improving treatment level of patients with acute ischemic stroke. MethodsThe differences of number of patients accepted venous thrombolysis, number of patients accepted emergency intravascular interventional treatment, and time from admission to intravenous thrombolysis (door to needle time [DNT]) were analyzed in patients with acute ischemic stroke admitted to our hospital in the first year (2016) and the second and third years (2017 and 2018) of construction of network platform for treatment and rescue of acute and severe cerebrovascular diseases in Yunfu city. The National Institutes of Health Stroke Scale (NIHSS) scores were compared in 120 patients selected randomly from online referral (study group, n=60) and non-online referral (control group, n=60) within the same time periods in 2018. ResultsIn 2017 and 2018, the number of patients accepted intravenous thrombolysis was 85 and 103, respectively, and the rate of intravenous thrombolysis was 9.92% and 9.83%;they were all significantly larger/higher than those in 2016 (n=50, 6.97%, P<0.05). In 2017 and 2018, the number of patients accepted emergency endovascular treatment was 56 and 129, respectively, and the emergency endovascular treatment rate was 6.53% and 12.31%;they were all higher than those in 2016 (n=44 and 6.14%), and the differences between those in 2018 and 2016 were statistically significant (P<0.05). The DNT ([82.00±18.75] min in 2017 and [77.00±32.17] min in 2018) was significantly shorter than that in 2016 ([109.00±30.58] min, P<0.05). The NIHSS scores of the study group and control group were 4.70±3.64 and 8.90±5.62, respectively, after one week of treatment, both of which were lower than those before treatment (14.30±6.29 and 13.60±6.37);and after treatment, the NIHSS scores of the treatment group were statistically lower than those of the control group (P<0.05). ConclusionConstruction and effective operation of network platform for treatment and rescue of acute and severe cerebrovascular diseases is an effective guarantee to improve the success rate of treatment for patients with acute ischemic stroke.