基于社区网格化管理的脑卒中急救体系研究

Study on First Aid System of Stroke based on Community Grid Management

目的探讨社区网格化管理模式对区域脑卒中急诊急救体系的建设成效。方法收集网格化管理前后1年入住我院卒中中心的新发脑卒中病例,对比前后病例数量、静脉溶栓率和患者抵达医院至溶栓的时间(door-to-needle time,DNT)、从发病至到院时间(onset-to-doortime,ODT)及120运送率等指标的变化。结果建设组收治的急性脑卒中的例数比建设前组多,建设组的静脉溶栓率15.37%也比建设前组的静脉溶栓率9.11%显著提高(P<0.05),建设组的DNT(44.97 min)比建设前组(56.04 min)明显缩短(P<0.05),建设组的ODT也比建设前组缩短,建设组的120运送率比建设前组提高,两者差异均具有统计学意义,而建设组的介入治疗率虽比建设前组高,但两者差异没有统计学差异。结论紧密型医共体内采用社区网格化管理模式构建的院内外“五位一体”脑卒中急诊急救体系有助于提升脑卒中的救治效率,能够有效改善患者预后结果。

Objective:To explore the effect of community grid management mode on the construction of regional stroke emergency system.Method:The new stroke cases admitted to the stroke center of our hospital 1 year before and after grid management were collected to compare the followings:the number of cases before and after,the rate of intravenous thrombolysis,the time from arrival to thrombolysis(door-to-needle time,DNT),the time from onset to discharge(onset-to-door time,ODT),120 delivery rate and other indicators.Result:The number of acute cerebral apoplexy cases admitted in the construction group was more than that in the pre-construction group.The intravenous thrombolysis rate of the construction group was 15.37%,which was significantly higher than that in the pre-construction group(9.11%)(P<0.05).The number of acute cerebral apoplexy cases admitted in the construction group was more than that in the pre-construction group.The intravenous thrombolysis rate of the construction group was 15.37%,which was significantly higher than that in the pre-construction group(9.11%)(P<0.05).The DNT(44.97 min)of the construction group was significantly shorter than that in the pre-construction group(56.04 min)(P<0.05).The ODT of the construction group was also shorter than that of the pre-construction group,and the 120 delivery rate of the construction group was higher than that of the pre-construction group,the differences between the two were statistically significant,while the interventional treatment rate of the construction group was higher than that of the pre-construction group,but there was no statistical difference between the two.Conclusion:The“five-in-one”emergency first-aid system for stroke inside and outside the hospital,which is constructed by using the community grid management mode,is helpful to improve the treatment efficiency of stroke and can effectively improve the prognosis of patients.