[1]钮 静,权文娟,赵春洪,等.优化静脉溶栓流程在改善急性缺血性脑卒中患者即时疗效的应用[J].医学信息,2021,34(20):139-141.[doi:10.3969/j.issn.1006-1959.2021.20.036]
　NIU Jing,QUAN Wen-juan,ZHAO Chun-hong,et al.Application of Optimizing Intravenous Thrombolysis Process in Improving Immediate Efficacy ofPatients with Acute Ischemic Stroke[J].Medical Information,2021,34(20):139-141.[doi:10.3969/j.issn.1006-1959.2021.20.036]
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优化静脉溶栓流程在改善急性缺血性脑卒中患者即时疗效的应用()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年20期
页码:
139-141
栏目:
临床研究
出版日期:
2021-10-20

文章信息/Info

Title:
Application of Optimizing Intravenous Thrombolysis Process in Improving Immediate Efficacy ofPatients with Acute Ischemic Stroke
文章编号:
1006-1959（2021）20-0139-03
作者:
钮 静; 权文娟; 赵春洪; 王红平
北京市大兴区中西医结合医院急诊科，北京 100076
Author(s):
NIU Jing; QUAN Wen-juan; ZHAO Chun-hong; WANG Hong-ping
Emergency Department,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China
关键词:
急性缺血性脑卒中; 优化静脉溶栓流程; DNT; NIHSS评分
Keywords:
Acute ischemic stroke; Optimize the intravenous thrombolysis process; Door-to-drug time;  NHISS score
分类号:
R743.31
DOI:
10.3969/j.issn.1006-1959.2021.20.036
文献标志码:
A
摘要:
目的 分析优化静脉溶栓流程管理前后我院急性缺血性脑卒中（AIS）患者到达医院到静脉溶栓时间（DNT）相关时间的和溶栓前后美国国立卫生研究院卒中量表（NHISS）评分的变化，评价溶栓即时疗效。方法 选择2017年1月-2020年11月我院AIS患者369例，均给予静脉溶栓流程管理，将优化前2017年1月-2018年6月采用静脉溶栓流程管理的87例患者归为对照组，优化后2018年7月-2020年11月采用优化静脉溶栓流程管理的282例患者归为观察组，比较两组就诊至神内医师会诊时间、就诊至CT报告时间、DNT，两组溶栓前、后NHISS评分，分析DNT时间与即时NHISS评分差值的相关性。结果 观察组就诊至CT报告时间、DNT均短于对照组（P＜0.05）；观察组就诊至神内医师会诊时间长于对照组（P＜0.05）；观察组DNT时间与NIHSS评分差值呈负相关（r=-0.125，P=0.036）。结论 优化静脉溶栓流程管理能缩短AIS患者DNT，DNT时间越短，NIHSS评分差值越大，溶栓效果越好，缩短DNT时间有助于改善患者即时疗效。
Abstract:
Objective To analyze the changes of door-to-drug related time (DNT) related time of patients with acute ischemic stroke (AIS) in our hospital before and after the optimization of intravenous thrombolysis process management and the score of National Institutes of Health Stroke Scale (NHISS) before and after thrombolysis, and to evaluate the immediate effect of thrombolysis.Methods A total of 369 AIS patients in our hospital from January 2017 to November 2020 were selected and given intravenous thrombolysis process management, while 87 patients with intravenous thrombolysis process management before optimization from January 2017 to June 2018 were classified as the control group, and 282 patients with intravenous thrombolysis process management after optimization from July 2018 to November 2020 were classified as the observation group. The time from visit to physician consultation, the time from visit to CT report, DNT and NHISS score before and after thrombolysis were compared between the two groups. The correlation between DNT time and immediate NHISS score difference was analyzed.Results The time from visit to CT report and DNT in the observation group were shorter than those in the control group(P<0.05). The observation group had longer consultation time from visiting doctor to physician(P<0.05). There was a negative correlation between DNT time and NIHSS score difference in the observation group (r=-0.125, P=0.036).Conclusion Optimized intravenous thrombolysis process management can shorten the DNT of AIS patients. The shorter the DNT time, the greater the difference of NIHSS score, the better the thrombolytic effect. Shortening the DNT time is helpful to improve the immediate effect of patients.

参考文献/References:

[1]张学梅,顾艳荭.急性缺血性脑卒中患者静脉溶栓情况及其影响因素的分析[J].中国医药指南,2015(8):31-33.[2]陈莉,钟华.79例AIS患者静脉溶栓DNT延长的影响因素分析[J].重庆医学,2020,49(15):2515-2518.[3]冼文川,符家武,张洁茵.96例急性脑梗死患者静脉溶栓DNT延长原因浅析[J].中国实用医药,2021,16(3):43-45.[4]解晨,谷有全.急诊绿色通道的优化对急性缺血性脑卒中患者静脉溶栓DNT改善的研究[J].中国实用神经疾病杂志,2019,22(17):1864-1869.[5]Powers WJ,Rabinstein AA,Ackerson T,et al.Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association[J].Stroke,2019,50(12):e344-e418.[6]中华医学会神经病学分会.《中国急性缺血性脑卒中诊治指南(2018年)[J].中华神经科杂志,2018,51(9):666-682.[7]吴满辉,林小鸿,黄云苑,等.急诊脑卒中绿色通道对急性缺血性卒中患者DNT的影响[J].岭南急诊医学杂志.2020,25(6):562-564.[8]中华医学会神经病学分会.《中国急性缺血性脑卒中诊治指南(2014年)[J].中华神经科杂志,2015,48(4):246-257.[9]路雅宁,吴跃华,林黎明.NIHSS评分对急性脑梗死的评估效力研究[J].国际老年医学杂志,2017,38(3):131-132,封3.[10]Wang Y,Cui L,Ji X,et al.The China National Stroke Registry for patients with acute Cerebrovascular events design, rationale, and baseline patient characteristics[J].Stroke,2011,64(4):355-361.[11]粟伟栋.AIS患者院内延误或未进行rt-PA静脉溶栓的影响因素分析[D].衡阳:南华大学,2018.[12]Ido MS,Okosun IS,Bayakly R,et al.Door to intravenous tissue plasminogen activa-tor time and hospital length of stay in acute is-chemic stroke patients,Georgia,2007-2013[J].J Stroke Cerebrovasc Dis,2016,25(4):866-871.[13]Toyoda K,Koga M,Iguchi Y,et al.Guidelines for intravenous thrombolysis(recombinant tissue-type plaaminogen activator),the third edition, March 2019: aguideline from the Japan stroke society[J].Neurol Med Chir(Tokyo),2019,59(12):449-491.[14]邓先锋,向莉,冯霞,等.急性缺血性脑卒中院前院内协作的溶栓急救绿色通道构建[J].临床急诊杂志,2019,20(11):860-865.[15]黄伟生,夏结婷.急诊绿色通道静脉溶栓治疗超急性期脑梗死患者临床效果及安全性研究[J].中国实用医药,2018,13(13):1-3.

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更新日期/Last Update: 1900-01-01