控制溶栓时间为基础急诊绿色通道在急性缺血性脑卒中溶栓急救护理中的价值

The Value of Controlling Thrombolysis Time Based Emergency Green Channel in Emergency Care of Thrombolysis in Acute Ischemic Stroke

目的 分析急性缺血性脑卒中(AIS)患者溶栓急救护理中实施以控制溶栓时间为基础的急诊绿色通道的效果。方法 选取2022年1月至12月我院急诊科实施急诊绿色通道前的60例AIS患者作为对照组,2023年1月至12月实施急诊绿色通道后的36例AIS患者作为研究组。对比两组溶栓相关指标、神经功能(NIHSS)、认知功能(MMSE)、功能残疾(mRS)、凝血指标、并发症。结果 相较对照组,研究组病情评估时间、静脉开通时间、CT检查完成时间、到达医院就诊至静脉溶栓用药时间、急诊停留时间均更短,溶栓率更高(P <0.05)。出院时,研究组NIHSS、mRS评分较对照组更低,MMSE评分较对照组更高(P <0.05)。治疗1 d时,研究组D-二聚体水平较对照组更高,纤维蛋白原水平较对照组更低(P <0.05)。研究组神经功能后遗症发生率更低(P <0.05)。结论 AIS患者实施以控制溶栓时间为基础急诊绿色通道,可明显加快溶栓急救工作效率,提升溶栓率,促进神经功能、认知功能恢复,调节凝血指标,改善预后。

Objective To analyze the effect of implementing emergency green channel based on controlling thrombolysis time in thrombolysis emergency care for patients with acute ischemic stroke(AIS).Methods A total of 60 AIS patients before the implementation of emergency green channel in the emergency department of our hospital from January to December 2022 were selected as the control group,and 36 AIS patients after the implementation of emergency green channel from January to December 2023 were selected as the study group.Thrombolysis-related indexes,neurological function(NIHSS),cognitive function(MMSE),functional disability(mRS),coagulation indexes,and complications were compared between the two groups.Results Compared with the control group,the study group had shorter time for condition assessment,time for vein opening,time for completion of CT examination,time for arrival at the hospital for consultation to intravenous thrombolysis medication,and stay time in the emergency room,and a higher thrombolysis rate(P<0.05).At discharge,the study group had lower NIHSS and mRS scores and higher MMSE scores than the control group(P<0.05).At 1 d of treatment,D-dimer levels were higher and fibrinogen levels were lower in the study group than in the control group(P<0.05).The incidence of neurological sequelae was lower in the study group(P<0.05).Conclusions The implementation of emergency green channel based on the control of thrombolysis time in AIS patients can significantly accelerate the efficiency of thrombolysis emergency work,improve the thrombolysis rate,promote the recovery of neurological function and cognitive function,regulate coagulation indexes,and improve the prognosis.