急诊启动急性缺血性脑卒中静脉内溶栓治疗对开始溶栓时间及安全性的影响

Effect of Intravenous Thrombolysis on Acute Ischemic Stroke in Emergency Department on the Average Time and Safety of Thrombolysis

目的分析急诊启动急性缺血性脑卒中静脉内溶栓治疗对开始溶栓时间及安全性的影响。方法回顾性分析2017年2月至2020年2月我院收治的62例急性缺血性脑卒中患者的病历资料。根据静脉内溶栓治疗时间窗的不同分为对照组和观察组,每组31例。对照组在病房启动静脉内溶栓治疗,观察组在急诊启动静脉内溶栓治疗。比较两组美国国立卫生院神经功能缺损评分(NIHSS)评分、格拉斯哥昏迷量表(GCS)评分、开始溶栓平均时间及症状性颅内出血发生率。结果治疗1 d后,观察组症状性颅内出血发生率为7.69%,对照组为5.13%,差异无统计学意义(P>0.05);治疗1周后,观察组NIHSS、GCS评分分别为(9.25±1.04)、(12.62±2.15)分,对照组分别为(9.33±1.08)、(12.45±2.11)分,差异均无统计学意义(均P>0.05);观察组开始溶栓时间平均为(90.34±26.12)min,对照组为(118.11±34.26)min,差异有统计学意义(P<0.05)。结论急诊和病房启动静脉内溶栓治疗急性缺血性脑卒中患者的疗效和安全性相当,但开始溶栓时间存有差别,建议急诊尽早启动静脉内溶栓治疗。

Objective To analyze the efficacy of emergency thrombolysis and emergency thrombolysis in the wards in the treatment of acute ischemic stroke and its impact on the average time and safety of thrombolysis.Methods A retrospective analysis of 62 patients with acute ischemic stroke admitted to our hospital from February 2017 to February 2020.According to the different timing of intravenous thrombolysis treatment,they were divided into control group and observation group,31 cases in each group.Patients in the control group started intravenous thrombolysis in the ward,and patients in the observation group started intravenous thrombolysis in the emergency department.The NIHSS score,GCS score,average time of start thrombolysis,and incidence of symptomatic intracranial hemorrhage were analyzed.Results After one day of treatment,the incidence of symptomatic intracranial hemorrhage in the observation group was 7.69%,which was not statistically significant compared to 5.13%in the control group(P>0.05).After one week of treatment,the NIHSS and GCS scores of the observation group were(9.25±1.04)and(12.62±2.15)points respectively,and the control group were(9.33±1.08)and(12.45±2.11)points,and there were no statistically significant difference(all P>0.05).The average time of start thrombolysis in the observation group was(90.34±26.12)min,and the control group was(118.11±34.26)min,the difference was statistically significant(P<0.05).Conclusion Intravenous thrombolysis in emergency department and intravenous thrombolysis in wards are effective and safe in the treatment of acute ischemic stroke,but the average time to start thrombolysis is different.It is recommended to start intravenous thrombolysis as soon as possible in emergency department.