急诊科过渡时间就诊对急性缺血性卒中溶栓治疗的影响

Effect of seeing a doctor during transition time in emergency department on thrombolytic therapy for acute ischemic stroke

目的 探讨急诊科过渡时间就诊对急性缺血性卒中溶栓治疗的影响。方法 抽取本院2017年12月~2018年11月间收治的98例急性缺血性卒中患者为研究对象,根据就诊时间分为对照组和观察组。对照组49例就诊时间为非换班期间前往医院就诊,观察组49例患者则是在换班期间进入急诊科室就诊,比较两组患者溶栓治疗效果。结果 观察组患者静脉开通时间、CT完成时间、脱离危险时间均长于对照组,差异有统计学意义(P<0.05),但是观察组溶栓时间(Door-to-Needle Time,DNT)和对照组差异无统计学意义(P>0.05),治疗6个月后,观察组生存质量评分(82.38±3.18)分明显低于对照组(88.25±2.91)分,差异有统计学意义(P<0.05),观察组死亡率6.12%,致残率为12.24%,虽然略低于对照组的10.20%、18.36%,但是两者之间的差异并不明显,无统计学意义(P>0.05)。结论急诊科过渡时间就诊对急性缺血性卒中溶栓治疗有一定影响,其中完成各项检查时间较慢,影响患者溶栓开始时间,且不利于患者术后生活能力的恢复。

Objective To investigate the effect of transition time visit in emergency department on thrombolytic therapy in acute ischemic stroke.Methods 98 patients with acute ischemic stroke who were admitted from December 2017 to November 2018 were enrolled in the study.They were divided into control group and observation group according to the time of treatment.49 patients in the control group were referred to the hospital during the non-shift period,and 49 patients in the observation group were admitted to the emergency department during the shift period.The effect of thrombolytic therapy was compared between the two groups.Results The venous access time,CT completion time,and out of danger time was longer in the observation group than that in the control group,and the difference was statistically significant(P<0.05).But the Door-to-Needle Time(DNT)in the observation group was no significantly different from that of the control group(P>0.05).After 6 months of treatment,the quality of life score(82.38±3.18)in the observation group was significantly lower than that in the control group(88.25±2.91),and the difference was statistically significant(P<0.05).The mortality and the disability rate in the observation group was 6.12%and 12.24%,slightly lower than 10.20%and 18.36%of the control group,but the difference between the two groups was not statistically significant(P>0.05).Conclusion Seeing a doctor during transition time in emergency department has certain influence on thrmbolytic therapy for acute ischemic stroke.The time for completing each inspection is slow,affecting the start time of thrombolysis,and is not conducive to the recovery of patients'postoperative ability.