分诊护士启动绿色通道对急性缺血性脑卒中救治时间的影响

Effect of triage nurse-initiated management of acute ischemic stroke

目的缩短急性缺血性脑卒中患者诊疗及静脉溶栓时间,提高有效救治率。方法将1580例于急诊科就诊的急性缺血性脑卒中患者,按卒中绿色通道启动者分为医生组544例、护士组1036例。比较两组评估准确率、静脉溶栓率及静脉溶栓救治时间。结果两组患者评估准确率、静脉溶栓比例比较,差异无统计学意义(均P>0.05);护士组患者进门到医生接诊、到静脉开通、到标本送达、到静脉溶栓时间显著短于医生组(均P<0.01)。结论对急性缺血性脑卒中患者,由分诊护士启动卒中绿色通道可显著缩短静脉溶栓时间,有利于提高溶栓效果。

Objective To shorten door-to-physician and door-to-needle time(the interval between arriving at the hospital and starting thrombolytic treatment)in patients with acute ischemic stroke(AIS)and to enhance rescue rate.Methods A total of 544 AIS patients received physician-initiated management protocol and 1036 counterparts were subjected to triage nurse-initiated management protocol.The accuracy of assessment,rate of thrombolytic treatment,and door-to-needle time were compared between the two groups.Results There were no significant differences between the two groups in the accuracy of assessment and rate of thrombolytic treatment(P>0.05 for both).Door-to-physician,door-to-venipuncture,door-to-sample-arrival,and door-to-needle in nurse-initiated group were significantly shortened than physician-initiated group(P<0.01 for all).Conclusion Triage nurse-initiated management of AIS would decrease door-to-needle time and increase the effectiveness of thrombolytic treatment.