基于循证支持的优化脑卒中绿色通道急诊独立模式在急性缺血性脑卒中患者中的应用价值

The application value of optimized stroke green channel emergency independent mode based on evidence-based support in patients with acute ischemic stroke

目的探讨基于循证支持的优化脑卒中绿色通道急诊独立模式在接受静脉溶栓治疗的急性缺血性脑卒中(AIS)患者中的应用价值。方法选取2021年1月至2022年12月在该院进行静脉溶栓治疗的AIS患者114例作为研究对象,根据入院顺序,将2021年1-12月收治的57例患者纳入常规组,将2022年1-12月收治的57例患者纳入优化组。常规组采用常规脑卒中绿色通道护理的急诊独立模式,优化组采用基于循证支持的优化脑卒中绿色通道急诊独立模式。比较两组急救效率、神经功能[美国国立卫生研究院卒中量表(NIHSS)评分]、救治效果、家属护理满意度。结果优化组入院接诊用时、采血送检用时、心电图检查用时、CT检查用时、签署知情同意书用时、入院至静脉溶栓时间均短于常规组,差异有统计学意义(P<0.05);优化组溶栓后24 h、溶栓后48 h、出院当天NIHSS评分均低于常规组,差异有统计学意义(P<0.05);优化组AIS再发率、致残率分别为0.00%、3.51%,低于常规组的10.91%、16.36%,差异有统计学意义(P<0.05);优化组住院时间短于常规组,差异有统计学意义(P<0.05);优化组家属护理满意度为98.25%,高于常规组的85.96%,差异有统计学意义(P<0.05)。结论基于循证支持的优化脑卒中绿色通道急诊独立模式应用于接受静脉溶栓治疗的AIS患者,可缩短溶栓等关键节点救治时间,改善神经功能,提升救治效果及家属护理满意度。

Objective To investigate the application value of optimized stroke green channel emergency independent mode based on evidence-based support in the treatment of acute ischemic stroke(AIS)by intravenous thrombolysis.Methods A total of 114 AIS patients who received intravenous thrombolysis in the First People′s Hospital of Zhengzhou from January 2021 to December 2022 were selected as objects.According to the admission order,57 patients admitted from January to December 2021 were classified into the routine group,and other 57 patients from January to December 2022 were classified into the optimized group.The routine group was given the independent emergency mode of routine stroke green channel nursing,and the optimized group was given the independent stroke green channel emergency mode based on evidence-based support.The first aid efficiency,neurological function[National Institute Health stroke scale(NIHSS)score],therapeutic effect and family nursing satisfaction were compared between the two groups.Results The time of admission,blood collection and examination,electrocardiogram detection,CT examination,signing of informed consent,from admission to intravenous thrombolysis in the optimized group was shorter than that in the routine group,the differences were statistically significant(P<0.05).After 24 h,48 h of thrombolysis and on the day of discharge,the NIHSS scores of the optimized group were lower than those of the routine group,the differences were statistically significant(P<0.05).The AIS recurrence rate and disability rate in the optimized group were 0.00% and 3.51% respectively,which were lower than those in the routine group(10.91% and 16.36%),the differences were statistically significant(P<0.05).The time of hospitalization in the optimized group was shorter than that in the routine group,the difference was statistically significant(P<0.05).The satisfaction of family nursing in the optimized group(98.25%)was higher than that in the routine group(85.96%),the difference was statistically significant(P<0.05).Conclusion The application of stroke green channel independent emergency mode based on evidence-based support in AIS patients undergoing intravenous thrombolytic therapy can shorten the treatment time of key nodes such as thrombolytic therapy,improve neurological function,and enhance the treatment effect and nursing satisfaction of family members.