急诊就诊流程关键环节控制在急性缺血性脑卒中患者静脉溶栓中的应用

Application of key link control in emergency treatment process in intravenous thrombolysis in patients with acute ischemic stroke

目的 探讨急诊就诊流程关键环节控制在急性缺血性脑卒中(AIS)患者静脉溶栓救治中的应用效果。方法 选取2018年8月—2019年7月在南京医科大学第一附属医院急诊就诊的AIS患者120例,按照常规脑卒中流程进行静脉溶栓,归为对照组;选取2019年8月-2020年7月在南京医科大学第一附属医院急诊就诊的AIS患者120例,按照急诊就诊流程关键环节控制进行静脉溶栓,归为实验组;比较两组AIS患者的一般资料,溶栓前美国国立卫生研究院卒中量表(NIHSS)评分,决策者学历,患者入院-分诊完成时间(A)、入院-医生接诊时间(B)、入院-建立静脉通路时间(C)、入院-检验完成时间(D)、入院-CT完成时间(E)、家属决策用时(F)、患者入院-静脉溶栓时间(DNT)、患者满意度。结果两组AIS患者的一般资料,溶栓前NIHSS评分,决策者学历比较差异无统计学意义(P>0.05),具有可比性;实验组患者入院-分诊完成时间(A)、入院-医生接诊时间(B)、入院-建立静脉通路时间(C)、入院-检验完成时间(D)、入院-CT完成时间(E)、家属决策用时(F)、患者入院-静脉溶栓时间(DNT)低于对照组,患者满意度高于对照组,差异均具有统计学意义(P<0.05)。结论 通过控制急诊就诊流程关键环节,可减少AIS患者就诊等待时间,促进家属进行溶栓决策,有效降低患者入院-静脉溶栓时间(DNT),提高患者满意度。

Objective To investigate the application effect of key link control in emergency treatment process in the treatment of acute ischemic stroke(AIS)patients with intravenous thrombolysis.Methods A total of 120 patients with AIS who visited the emergency department of the First Affiliated Hospital of Nanjing Medical University from August 2018 to July 2019 were selected and classified as the control group after intravenous thrombolysis according to conventional stroke procedures.A total of 120 patients with AIS who visited the emergency department of the First Affiliated Hospital of Nanjing Medical University from August 2019 to July 2020 were selected to receive intravenous thrombolysis according to the key link of the emergency treatment process and classified as the experimental group.The general data,pre-thrombolysis National Institutes of Health Stroke Scale(NIHSS)score,decision-maker's education,patient admission-completion time of triage(A),admission-doctor's reception time(B),admission-establishment of venous access time(C),admission-test completion time(D),admission-CT completion time(E),family decision time(F),admission-intravenous thrombolysis time(DNT),patient satisfaction were compared between the two group.Results There were no statistically significant differences in the general information,NIHSS score before thrombolysis and educational background of decision-makers between the two groups of AIS patients(P>0.05),The input-triage completion time(A),input-doctor reception time(B),input-venous access establishment time(C),input-test completion time(D),input-CT completion time(E),family decision time(F),input-intravenous thrombolysis time(DNT)of the experimental group were lower than those of the control group,and the patient satisfaction was higher than that of the control group.The differences were statistically significant(P<0.05).Conclusion By controlling the key aspects of the emergency treatment process,the waiting time of AIS patients can be reduced,the thrombolysis decision of family members can be promoted,the DNT time can be effectively reduced,and the patient satisfaction can be improved.