| 摘要: |
| 目的评估急性缺血性脑卒中溶栓流程实施的多科协作优化改进,对缩短患者到院就诊至启动重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)静脉溶栓治疗时间(door-to-needle time,DNT)的效果。方法 2014年8月至2015年7月对溶栓流程的具体实施进行多学科协作优化改进的患者入试验组,按时间分为两个阶段:2014年8月至2015年1月为试验第一阶段,2015年2月至2015年7月为试验第二阶段;2014年1月至7月改进前rt-PA静脉溶栓的急性缺血性卒中患者入对照组。比较各组患者DNT时间、溶栓率和治疗效果。结果 DNT平均值由对照组的88min缩短到试验第二阶段的61min,差异有统计学意义(P<0.05)。对照组DNT≤60min的比例达为20%,试验第二阶段达51.2%。美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、改良Rankin量表(MRS)评分,试验第二阶段优于对照组。结论通过多学科配协作,对溶栓流程的实施优化,可以减少rt-PA静脉溶栓的院内延误时间,改善患者预后。 |
| 关键词: 缺血性卒中 静脉溶栓 到院就诊至启动rt-PA静脉溶栓治疗时间 多科协作 |
| DOI： |
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| 基金项目:成都市卫计委课题(编号:2015005);成都市科技局科技惠民技术研发项目(编号:2015-HM01-00240-SF) |
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| Application Study of Shortening Hospital Delay in Ultra-early Stage of Acute Ischemic Stroke Patients |
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Wang Lei;Jiang Shuai;Luo Yetao1,2
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1.The Third People’s Hospital of Chengdu·Affiliated Hospital of Southwest Jiaotong University;2.Department of Statistics,School of Public Health and Management,Medical University of Chongqing
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| Abstract: |
| Objective To evaluate the effect of multidisciplinary collaboration in execution of thrombolysis for acute ischemic stroke on reducing door-to-needle time(DNT).Methods During August 2014 to July 2015,patients who underwent thrombolysis optimized by MDT were attributed to experimental group,divided into two stages according to time-August 2014 to January 2015 as first stage and February 2015 to July 2015 as second stage.Patients with acute ischemic stroke underwent recombinant tissue plasminogen activator(rt-PA) intravenous thrombolysis before optimization during January 2014 to July 2014,were attributed to control group.DNTs,thrombolysis rates and therapeutic effect of each group were compared.Results The average value of DNT reduced from 88 minutes of control group to 61 minutes of experimental group in second stage,the difference being statistically significant(P< 0.05).Ratio of DNT shorter than 60 minutes in control group was 20% and that in experimental group of second stage was 51.2%.As for scoring of National Institute of Health Stroke Scale(NIHSS) and Modified Rankin Scale(MRS),experimental group of the second stage was superior to control group.Conclusion Through multidisciplinary collaboration,optimization of thrombolytic process can reduce the hospital delay time of rt-PA intravenous thrombolysis and improve the prognosis of patients. |
| Key words: ischemicstroke thrombolysis door-to-needletime multidisciplinarycollaboration |
