探讨新型冠状病毒流行对大连市急性缺血性卒中患者静脉溶栓治疗的影响

The influence of the prevalence of covid-19 on intravenous thrombolytic therapy in patients with acute ischemic stroke in Dalian

目的探讨2020年大连市急性缺血性卒中(AIS)患者静脉溶栓治疗数量、来院方式、出现症状至到达医院的时间(ODT)、到达医院至开始静脉溶栓治疗时间(DNT)、出现症状至开始用药时间(ONT)以及溶栓前后美国国立卫生研究院神经功能缺损评分(NIHSS)是否受到新型冠状病毒疫情流行的影响。方法对大连市13家卒中急救地图参与医院进行回顾描述性研究,选取2020年8-12月于13家医院行静脉溶栓治疗的AIS患者:ODT、DNT、ONT、到达医院的运输方式、到达医院时NIHSS评分及溶栓后即刻NIHSS评分等。数据采集工作2020年8月1日-12月31日,并与2019年同期基线数据进行对比。结果采用SPSS 22.0软件及Excel的分析工具库对获取数据进行统计分析,使用Student t检验进行数据分析:2020年接受静脉溶栓治疗的AIS患者例数增加(681例比416例),DNT中位数延长[50比45(P=0.01)];2020年83.55%的患者选择自行前往医院就诊的交通方式;2020年NIHSS<15分自行就诊的卒中患者静脉溶栓前及溶栓后即刻NIHSS评分不变及减少的患者为多数(95%),且NIHSS评分减少程度比较差异有统计学意义(562分比535分,P<0.001),NIHSS评分≥15分的卒中患者更愿意呼叫救护车到医院就诊。结论2020年新型冠状病毒流行期间,接受静脉溶栓治疗的AIS患者数量增加,但DNT中位数延长;NIHSS评分<15分患者更多自行来院就诊,且从静脉溶栓中获益,NIHSS≥15分卒中患者更愿意呼叫救护车到医院就诊。

Objective To investigate the influence of Covid-19 epidemic on the number of acute ischemic stroke patients with intravenous thrombolytic therapy in Dalian in 2020,the way to hospital,onset to door time(ODT),door to needle time(DNT),onset to needle time(ONT),and the National Institute of Health Stroke Scale(NIHSS)before and after intravenous thrombolytic therapy.Methods This was a retrospective descriptive study on 13 map-participating hospitals in Dalian from August 2020 to December 2020.The number of acute ischemic stroke patients with intravenous thrombolytic therapy,ODT,DNT,ONT,modes of transport to hospital,the NIHSS score before and after intravenous thrombolytic therapy,etc were analyzed.Data were collected from August 1,2020 to December 31,2020,and compared with the baseline data from the same period in 2019.Results SPSS 22.0 statistical software and Data Analysis ToolPak were used for statistical analysis of the obtained data,and T tests statistic was used for data analysis.In 2020,the number of acute ischemic stroke patients with intravenous thrombolytic therapy increased(681 cases vs 416 cases),and DNT increased[50 minutes vs 45 minutes P=0.01].In 2020,83.55%of patients indicated self-visit as their main mode of transport to the hospital.In 2020,among the self-visit patients with NIHSS score<15 scores,the number of the patients with the NHISS score unchanged or decreased after intravenous thrombolytic therapy was more(562 scores vs.535 scores,P<0.001),and the patients with NIHSS score≥15 scores were more willing to call ambulances to hospital.Conclusions During the Covid-19 epidemic period of 2020,the number of acute ischemic stroke patients receiving intravenous thrombolytic therapy increased,DNT increase;the patients withNIHSS score<15 scores are more willing to choose to visit the hospital using their own transportation and benefit from intravenous thrombolytic therapy.The patients with NIHSS≥15 scores prefer to call ambulances to hospital.