优化急诊绿色通道在急性脑梗死患者中的应用及效果评价

Application and effect evaluation of optimizing emergency green channel in patients with acute cerebral infarction

目的探讨应用优化急诊绿色通道静脉溶栓流程及护理干预对救治急性脑梗死患者的效果评价.方法选取首都医科大学附属北京天坛医院急诊科2018年1月1日至12月31日收治的45例急性脑梗死患者为观察组,采用优化后的绿色通道静脉溶栓流程及护理干预行溶栓治疗,选取2017年1月1日至12月31日收治的45例脑梗死患者为对照组,采用传统流程及护理干预行静脉溶栓治疗.比较2组患者从就诊到开始溶栓药物用药时间(DNT)、住院时间、急诊床位周转率以及溶栓前后神经功能缺损(NIHSS)评分.结果对照组患者DNT时间、住院时间、急诊床位周转率分别为(82.82±9.73)min、(11.31±2.96)d、22.07(1280/58),观察组分别为(37.62±8.40)min、(7.33±1.16)d、31.93(1852/58),2组比较差异有统计学意义(t=25.526、8.926,χ^2=10.526,P<0.01或0.05).入院时2组NIHSS评分比较差异无统计学意义(P>0.05);出院时观察组NIHSS评分为(3.13±2.00)分,明显低于对照组的(7.33±1.95)分,差异有统计学意义(t=8.469,P<0.05).结论急性脑梗死患者的治愈率与救治及时性存在着重要关联,而经由快速绿色通道的建立,使患者不错过最佳时机,同时有助于促进神经功能恢复,从而达到提升患者治愈率的效果.

Objective To explore the effect of optimizing the green channel intravenous thrombolysis process and nursing intervention in the treatment of acute cerebral infarction.Methods Forty-five patients with acute cerebral infarction admitted to emergency department of Beijing Tiantan Hospital Affiliated to Capital Medical University in 2018 were selected as observation group,and 45 patients with cerebral infarction admitted in 2017 were selected as control group,and treated with traditional process and nursing intervention.Door to needle time(DNT),hospitalization time,Emergency bed turnover rate and National Institute of Health Stroke Scale(NIHSS)scores before and after thrombolysis were compared between the two groups.Results The DNT time,hospitalization time and emergency bed turnover rate in the control group were(82.82±9.73)min,(11.31±2.96)days and 22.07(1280/58),respectively,while those in the observation group were(37.62±8.40)min,(7.33±1.16)days and 31.93(1852/58),respectively.There were significant differences between the two groups(t=25.526,8.926,χ^2=10.526,P<0.01 or 0.05).There was no significant difference in NIHSS scores between the two groups at admission(P>0.05);the NIHSS score of the observation group at discharge was 3.13±2.00,which was significantly lower than that of the control group(7.33±1.95),and the difference was statistically significant(t=8.469,P<0.05).Conclusion The cure rate of patients with acute cerebral infarction is closely related to the timeliness of treatment.The establishment of fast green channel can not miss the best opportunity for patients,but also help to promote the recovery of nerve function,so as to achieve the effect of improving the cure rate of patients.