序贯评估病情对急性缺血性脑卒中院前急救效率及临床结局的影响

Effect of sequential assessment of conditions on the efficiency of prehospital emergency care and clinical outcomes in acute ischemic stroke

目的分析序贯评估病情对急性缺血性脑卒中院前急救效率及临床结局的影响。方法回顾性分析110例急性缺血性脑卒中患者的临床资料,根据分诊方式分为对照组(55例,常规急诊分诊)及观察组(55例,给予序贯方式评估病情)。比较两组患者临床指标[急救前评估时间、呼救至治疗时间、医院反应时间、格拉斯哥预后评分量表(GOS)评分]、并发症发生情况、救治效果及死亡情况。结果观察组患者急救前评估时间(4.36±1.15)min、呼救至治疗时间(12.16±5.86)min、医院反应时间(5.26±2.15)min短于对照组的(7.56±1.36)、(22.36±5.58)、(17.54±5.25)min,GOS评分(4.15±0.42)分明显高于对照组的(3.48±0.56)分(P<0.05)。观察组患者中枢性高热、直肠功能障碍、肺部感染、肝肾功异常发生率分别为20.00%、3.64%、1.82%、0,明显低于对照组的38.18%、16.36%、12.73%、7.27%(P<0.05)。观察组患者治疗总有效率87.27%明显高于对照组的56.36%,死亡率1.82%明显低于对照组的12.73%(P<0.05)。结论序贯评估病情能提高急性缺血性脑卒中的院前急救效率,缩短整体急救时间,增加患者治愈率,降低患者死亡风险。

Objective To analyze the effect of sequential assessment of conditions on the efficiency of prehospital emergency care and clinical outcomes in acute ischemic stroke.Methods The clinical data of 110 acute ischemic stroke patients were retrospectively analyzed,and the patients were divided into a control group(55 cases,conventional emergency triage)and an observation group(55 cases,sequential assessment of conditions)according to the triage mode.The clinical indicators[pre-emergency assessment time,call-to-treatment time,hospital response time,Glasgow Outcome Scale(GOS)score],occurrence of complications,treatment effect and death were compared between the two groups.Results The pre-emergency assessment time,call-to-treatment time and hospital response time in the observation group were(4.36±1.15),(12.16±5.86)and(5.26±2.15)min,which were shorter than(7.56±1.36),(22.36±5.58)and(17.54±5.25)min in the control group;the observation group had significantly higher GOS score of(4.15±0.42)points than(3.48±0.56)points in the control group(P<0.05).The incidence of central hyperthermia,rectal dysfunction,pulmonary infection and abnormal liver and kidney function in the observation group were 20.00%,3.64%,1.82%and 0,which were significantly lower than 38.18%,16.36%,12.73%and 7.27%in the control group(P<0.05).The total effective rate of 87.27%in the observation group was significantly higher than 56.36%in the control group,and the mortality rate of 1.82%was significantly lower than 12.73%in the control group(P<0.05).Conclusion Sequential assessment of the condition can improve the efficiency of pre-hospital emergency care for acute ischemic stroke,shorten the overall emergency time,increase the cure rate of patients,and reduce the risk of patient death.