院前院内一体化模式在急性缺血性脑卒中患者静脉溶栓中的应用

Application of pre-hospital and in-hospital integration model in intravenous thrombolysis in patients with acute ischemic stroke

目的探讨院前院内一体化模式在急性缺血性脑卒中(AIS)患者静脉溶栓中的应用效果。方法选取2019年1月~2020年2月于锦州医科大学附属第一医院采用院前院内一体化模式救治的静脉溶栓AIS患者78例为观察组,并选取同期由家属护送入院接受静脉溶栓的AIS患者84例为对照组。比较两组患者一般临床资料、卒中急救时间[发病至溶栓时间(ONT)、入院至溶栓时间(DNT)、入院至获得影像结果时间(DTI)、入院至获得检验结果时间(DTE)和DNT≤60 min比例]、临床疗效及预后指标。结果两组患者一般临床资料比较,差异无统计学意义(P>0.05),观察组患者ONT、DNT、DTI均短于对照组,DNT≤60 min比例高于对照组,差异有统计学意义(P<0.05),DTE在两组间比较差异无统计学意义(P>0.05),观察组临床总有效率为96.2%,高于对照组的83.3%,差异有统计学意义(P<0.05),观察组患者预后不良率为14.1%,低于对照组的28.6%,差异有统计学意义(P<0.05)。结论院前院内一体化模式可有效缩短AIS患者溶栓治疗的时间延误,有利于提高临床疗效,改善临床预后。

Objective To investigate the effect of pre-hospital and in-hospital integration model on intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods Seventy-eight AIS patients with intravenous thrombolysis who were treated with the pre-hospital and in-hospital integrated treatment mode in the First Affiliated Hospital of Jinzhou Medical University from January 2019 to February 2020 were selected as the observation group.Eighty-four AIS patients escorted by their family members to the hospital for intravenous thrombolysis were selected as the control group.General clinical data,stroke emergency time[the onset to thrombolysis(ONT),admission to thrombolysis(DNT),admission to imaging results(DTI),admission to test results(DTE)and proportions of DNT≤60 min],as well as clinical efficacy and prognostic indicators in the two groups were compared.Results The difference in general clinical data between the groups had no statistical significance(P>0.05).The ONT,DNT and DTI of the observation group were shorter than those of the control group.The proportion of DNT equal to 60 min or less was higher than that of the control group,and the difference was statistically significant(P<0.05).The difference in DTE between the two groups had no statistical significance(P>0.05).The total clinical effective rate of the observation group was 96.2%,higher than that(83.3%)of control group,and the difference was statistically significant(P<0.05).The prognosis defective rate of the observation group was 14.1%,less than 28.6%in the control group,and the difference was statistically significant(P<0.05).Conclusion The pre-hospital and in-hospital integration model can effectively shorten the time delay of thrombolytic therapy for AIS patients,and is conducive to improving the clinical efficacy and prognosis.