急救路径在老年急性脑卒中患者院前急救中的应用价值

Application value of first-aid pathway in pre-hospital emergency treatment for elderly patients with acute stroke

目的探讨急救路径在老年急性脑卒中患者院前急救中的应用价值。方法选取镇江市急救中心2017年8月至2021年8月接诊的104例老年急性脑卒中患者为研究对象,所有患者均伴有不同程度的休克、舌强言塞、口眼歪斜、四肢不利等症,经临床相关检查确诊为急性脑卒中,首次发病,发病后拨打"120"急救电话求救。按照患者是否接受急救路径分为研究组和对照组,每组52例。对照组中男性30例,女性22例;年龄60~85岁,平均(75.41±3.38)岁;平均格拉斯哥昏迷(glasgow coma scale,GCS)评分(6.75±1.08)分。研究组中男性28例,女性24例;年龄62~84岁,平均(74.89±3.55)岁;平均GCS评分(6.81±1.12)分。对照组患者接受常规急救,研究组患者接受急救路径,比较两组患者接诊至院前急救时间、接诊至接受专业救治时间、急救有效率、病死率及伤残率、神经功能损伤及生活质量。结果研究组患者接诊至院前急救时间、接诊至接受专业救治时间较对照组更短,组间数据差异有统计学意义(P<0.05);急救有效率显著高于对照组,死亡及伤残率显著低于对照组,组间数据差异有统计学意义(P<0.05);研究组患者NIHSS评分显著低于对照组,生活质量各项目评分显著高于对照组,组间数据差异有统计学意义(P<0.05)。结论急救路径有助于抓紧黄金抢救期,提高急救及预后效果,降低神经功能损伤,提高后期生活质量,在老年急性脑卒中患者院前急救中具有较高的应用价值。

Objective To explore the application value of first-aid pathway in pre-hospital emergency treatment for elderly patients with acute stroke.Methods 104 elderly patients with acute stroke admitted by Zhenjiang emergency center from August 2017 to August 2021 were selected as the research object.All patients were accompanied with varying degrees of shock,tongue obstruction,mouth eye deviation,limb disadvantage and other diseases.They were diagnosed as acute stroke after clinical examination.They first came on.After onset,they called"120"emergency telephone for help.The patients were divided into study group and control group according to whether they received the first aid path or not,with 52 cases in each group.In the control group,there were 30 males and 22 females;The age ranged from 60 to 85 years,with an average of(75.41±3.38)years;The average GCS score was(6.75±1.08).There were 28 males and 24 females in the study group;The age ranged from 62 to 84 years,with an average of(74.89±3.55)years;The average GCS score was(6.81±1.12).The patients in the control group received routine first aid and the patients in the study group received first aid path.The time from reception to pre hospital first aid,the time from reception to professional treatment,the effective rate of first aid,mortality and disability rate,neurological injury and quality of life were compared between the two groups.Results The time from reception to pre-hospital first-aid and from reception to professional treatment in the study group were shorter than those in the control group(P<0.05);the death and disability rate was significantly lower than that of the control group(P<0.05);the NIHSS score of patients in the study group was significantly lower than the control group,and the scores of various items of quality of life were significantly higher than the control group(P<0.05).Conclusion The first-aid path is helpful to grasp the golden rescue period,improve the effect of first-aid and prognosis,reduce neurological injury and improve the later quality of life.It has high application value in the pre-hospital first-aid of elderly patients with acute stroke.