急性缺血性脑卒中院前院内协作的溶栓急救绿色通道构建

Emergency green channel management of patients with acute ischemic stroke based on the pre-hospital and intra-hospital cooperation mode

目的:通过构建急性缺血性脑卒中患者溶栓急救绿色通道,缩短脑卒中患者就医延误的时间。方法:选取2017-01-2018-12期间在我院接受静脉溶栓治疗的急性缺血性脑卒中患者267例为研究对象,依据收治时间分为对照组59例,观察组208例。对照组采用常规急救模式,观察组采用院前院内协作的模式构建绿色通道进行急救。结果:溶栓率由5.02%升至14.02%(P<0.01);患者发病至开始治疗的时间(onset to treatment time,OTT)由241.47 min降至167.55 min(P<0.01);患者入院至溶栓用药时间(door to needle time,DNT)从72.51 min缩短至43.69 min(P<0.01);DNT≤60 min的患者比例从49.15%上升至86.54%(P<0.01);脑血管再通率由25.42%提高到59.13%(P<0.01);出院时NIHSS值观察组低于对照组(P<0.01)。结论:运用院前院内协作的模式构建溶栓急救绿色通道,整合多学科医疗资源,有效减少急性缺血性脑卒中患者就医延误的时间。

Objective:By constructing a green channel for thrombolytic emergency treatment in patients with acute ischemic stroke,so as to reduce the time of pre-hospital and intra-hospital delays.Method:A total of 267 AIS patients who received intravenous thrombolysis treatment from January 2017 to December 2018 were selected as the study subjects.According to the treatment time,the subjects were divided into the control group(59 cases)and the observation group(208 cases).The control group were subjected to routine rescue mode,while the observation group were subjected to construct the green channel for the pre-hospital and intra-hospital cooperation mode.Result:The rate of thrombolysis increased from 5.02%to 14.02%(P<0.01).Onset to treatment time(OTT)was reduced from 241.47 min to 167.55 min(P<0.01).The door to needle time(DNT)was reduced from 72.51 min to 43.69 min(P<0.01).The ratio of patients with the DNT≤60 minutes was increased from 49.15%to 86.54%(P<0.01).The rate of cerebrovascular recanalization was increased from 25.42%to 59.13%(P<0.01).At discharge,the NIHSS score of the observation group was lower than that of the control group(P<0.01).Conclusion:The green channel of construction based on the pre-hospital and intra-hospital cooperation mode can effectively reduce the pre-hospital delay and intra-hospital delay of acute ischemic stroke.