我国卒中中心绿色通道建设模式与发展

Green channel construction mode and development of stroke center in China

脑卒中造成全球社会经济负担。国内外多项指南推荐急性缺血性卒中患者尽早进行静脉溶栓治疗和血管内介入治疗,但因其时间依赖性强而临床应用受限。现阶段我国急性卒中救治仍存在就诊流程落后、卒中专业团队人力不足等各种问题。建立完善的脑卒中绿色通道并保障其顺利运行是推广溶栓治疗最重要且最有效的途径,不仅需要明确目标时间、适当调整医院布局及硬件软件投入、重视团队建设、明确岗位职责,更重要的是进行绿色通道流程改进,以"并联模式"替代"串联模式",同时可结合卒中急救地图发布,院前院内紧密衔接,普及卒中相关知识等措施。我国脑卒中绿色通道建设近年来已取得了相当的进展,推广上述改革模式,可最大限度地减少院前及院内延误,扩大卒中获益人群,提高急性缺血性卒中早期救治率。

Stroke poses a social and economic burden worldwide.Intravenous thrombolytic therapy and endovascular interventional therapy are recommended as early as possible for patients with acute ischemic stroke in many national and international guidelines,however,their clinical applications are limited due to their strong time dependence.To date,the treatment of acute stroke in China has many problems,such as backward development of hospital treatment process and shortage of stroke professionals.Establishing a complete stroke green channel and maintaining its smooth operation contributes to the most important and effective way to promote thrombolytic therapy,which requires setting a clear target time,appropriately adjusting the hospital layout and hardware and software investment,attaching importance to team building and clear job responsibilities.Moreover,the most important task is to improve the green channel process through replacing the"serial mode"with the"parallel mode",making full use of the first aid map of stroke,bridging the gap between pre-hospital and in-hospital treatment,and popularizing stroke-related knowledge.In recent years,considerable progress has been made in the construction of stroke green channel in China.The implementation of the above-mentioned reform mode may minimize pre-hospital and in-hospital delays,expand the benefit population of stroke and thus improve the early treatment rate of acute ischemic stroke.