优化静脉溶栓流程在改善急性缺血性脑卒中患者即时疗效的应用

Application of Optimizing Intravenous Thrombolysis Process in Improving Immediate Efficacy of Patients with Acute Ischemic Stroke

目的分析优化静脉溶栓流程管理前后我院急性缺血性脑卒中(AIS)患者到达医院到静脉溶栓时间(DNT)相关时间的和溶栓前后美国国立卫生研究院卒中量表(NHISS)评分的变化,评价溶栓即时疗效。方法选择2017年1月-2020年11月我院AIS患者369例,均给予静脉溶栓流程管理,将优化前2017年1月-2018年6月采用静脉溶栓流程管理的87例患者归为对照组,优化后2018年7月-2020年11月采用优化静脉溶栓流程管理的282例患者归为观察组,比较两组就诊至神内医师会诊时间、就诊至CT报告时间、DNT,两组溶栓前、后NHISS评分,分析DNT时间与即时NHISS评分差值的相关性。结果观察组就诊至CT报告时间、DNT均短于对照组(P<0.05);观察组就诊至神内医师会诊时间长于对照组(P<0.05);观察组DNT时间与NIHSS评分差值呈负相关(r=-0.125,P=0.036)。结论优化静脉溶栓流程管理能缩短AIS患者DNT,DNT时间越短,NIHSS评分差值越大,溶栓效果越好,缩短DNT时间有助于改善患者即时疗效。

Objective To analyze the changes of door-to-drug related time(DNT)related time of patients with acute ischemic stroke(AIS)in our hospital before and after the optimization of intravenous thrombolysis process management and the score of National Institutes of Health Stroke Scale(NHISS)before and after thrombolysis,and to evaluate the immediate effect of thrombolysis.Methods A total of 369 AIS patients in our hospital from January 2017 to November 2020 were selected and given intravenous thrombolysis process management,while 87 patients with intravenous thrombolysis process management before optimization from January 2017 to June 2018 were classified as the control group,and 282 patients with intravenous thrombolysis process management after optimization from July 2018 to November 2020 were classified as the observation group.The time from visit to physician consultation,the time from visit to CT report,DNT and NHISS score before and after thrombolysis were compared between the two groups.The correlation between DNT time and immediate NHISS score difference was analyzed.Results The time from visit to CT report and DNT in the observation group were shorter than those in the control group(P<0.05).The observation group had longer consultation time from visiting doctor to physician(P<0.05).There was a negative correlation between DNT time and NIHSS score difference in the observation group(r=-0.125,P=0.036).Conclusion Optimized intravenous thrombolysis process management can shorten the DNT of AIS patients.The shorter the DNT time,the greater the difference of NIHSS score,the better the thrombolytic effect.Shortening the DNT time is helpful to improve the immediate effect of patients.