智慧质控下脑卒中患者预见性接救治模式设计

The design of predictive treatment mode for stroke patients in brain under intelligent quality control

目的 评价智慧质控脑卒中患者预见性接救治模式的可行性,为患者救治效率提供新方向。方法 选取2016年6月—2020年2月就诊于南方医科大学南方医院急诊科脑卒中患者,设置2018年1月之前的患者为对照组,其余时间段患者为试验组。对照组进行常规救治,试验组进行预见性接救治,对比两组患者静脉溶栓时间(DNT)和入院到股动脉穿刺时间(DPT)、接救治流程关键环节时间、患者满意度、患者结局。结果预见性接救治模式前后DNT分别为28.2 min和20.9 min,DPT分别为89.6 min和70.0min,差异有统计学意义(P<0.05)。试验组和对照组的生存期(OS)和局部控制(LC)曲线的差异有统计学意义(P<0.05)。实施预见性接救治模式后,住院花费减少3 958元,症状性颅内出血率下降1.15%;治疗90 d后mRS评分两组患者症状性颅内出血率增加4.66,三者的差异有统计学意义(P>0.05)。实施预见性接救治模式后救治团队成员满意度显著高于实施前(P<0.05)。结论 脑卒中患者预见性接救治模式能够显著提高救治总体有效率,且能提高救治团队满意度评分。

ObjectiveTo evaluate the feasibility of predictive treatment mode for stroke patients in the brain and provide a new direction for the efficiency of patients’treatment.MethodsStroke patients in the Emergency Department of our hospital from June 2016 to February 2020 were selected.Patients before January 2018 were set as the control group,and patients in other periods were set as the experimental group.The control group was treated with routine treatment,the experimental group was treated with predictive treatment,and DNT and DPT were compared between the two groups.The key links of treatment process,patient satisfaction and patient outcome were received.ResultsThe DNT was 28.2 min and 20.9 min before and after the predictive treatment mode,and the DPT was 89.6min and 70.0 min respectively,the difference was significant(P<0.05).There was significant difference between the experimental group and the control group(P<0.05).After the implementation of the predictive treatment mode,the cost of hospitalization decreased by 3958 yuan,and the bleeding rate of symptomatic intracranial decreased by 1.15%.After 90 days of treatment,the rate of symptomatic intracranial hemorrhage increased by 4.66 in the two groups(P>0.05),and the satisfaction of the members of the treatment team was significantly higher than that before the model implementation(P<0.05).ConclusionThe predictive treatment mode of stroke patients in brain can significantly improve the overall effective rate of treatment and improve the satisfaction score of the treatment team.