优化影像检查对急性缺血性脑卒中患者静脉溶栓治疗时间的影响

Effect of optimized imaging on the duration of intravenous thrombolysis in patients with acute ischemic stroke

目的:分析优化影像检查对急性缺血性脑卒中(AIS)患者到医院后至开始静脉使用重组组织型纤溶酶原激活剂(rt-PA)溶栓治疗时间(DNT)的影响。方法:抽样法选取2019年6至12月实行常规影像检查的100例AIS患者作为A组,将2020年1至8月采用优化影像检查100例AIS患者为B组。对比分析这两组AIS患者抵达CT室至完成检查时间、从发病至给予rt-PA用药时间(ONT)、DNT及治疗3个月后预后不好率、病死率及溶栓无效率等指标。结果:(1)二组治疗前患者影像检查及溶栓时间指标比较,其患者抵达CT室至完成检查时间、DNT、ONT A组分别为(13.69±3.25)分、(53.20±6.03)分、(167.73±12.5)分均高于B组(8.22±1.10)分、(31.25±2.25)分、(153.50±8.50)分,两组之间差异有统计学意义(P<0.05)。(2)二组治疗后效果指标比较,其预后不好率、病死率及溶栓无效率A组分别为50%、10%、48%均高于B组25%、2%、32%,两组之间差异有统计学意义(P<0.05)。结论:优化影像检查模式可缩短DNT时间,避免延误治疗,改善AIS静脉溶栓预后。

Objective:To analyze the effect of optimized imaging on the time(DNT)of intravenous use of recombinant tissue plasminogen activator(rt-PA)in patients with acute ischemic stroke(AIS)after arrival at the hospital.Methods:A total of 100 patients with AIS who underwent routine imaging examination from June to December 2019 were selected as group A by sampling method,and 100 patients with AIS who underwent optimized imaging examination mode from January to August 2020 were selected as group B.The time from arrival at the CT room to completion of examination,the time from onset to rt-PA administration(ONT),DNT and the rate of poor prognosis after 3 months of treatment,mortality and inefficiency of thrombolysis were compared and analyzed in the two groups of AIS patients.The time from arrival at the CT room to completion of examination,the time from onset to rt-PA administration(ONT),DNT and the rate of poor prognosis after 3 months of treatment,mortality and inefficiency of thrombolysis were compared and analyzed in the two groups of AIS patients.Results:(1)Comparison of imaging examination and thrombolytic time indexes between the two groups before treatment The time between arrival at CT room and completion of examination,DNT and ONT in group A were(13.69±3.25),(53.20±6.03)and(167.73±12.5)points,respectively,higher than those in group B(8.22±1.10),(31.25±2.25)and(153.50±8.50)points.There was statistical significance between the two groups(P<0.05).(2)After treatment,the poor prognosis rate,mortality rate and thrombolysis inefficiency rat of group A were 50%,10%and 48%,respectively,which were higher than those of group B(25%,2%and 32%),and the difference between the two groups was statistically significant(P<0.05).Conclusion:Optimization of imaging examination mode can shorten DNT time,help to avoid delayed treatment and improve the prognosis of AIS intravenous thrombolysis.