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急诊绿色通道综合管理策略在急性缺血性脑卒中静脉溶栓治疗中的应用

The application of the emergency green channel integrated management strategy in intravenous thrombolytic therapy for AIS.

作者信息

Zhang Hui, Zhang Bin, Chen Jie

机构信息

Department of Nursing, Tongling Vocational and Technical College Tongling, Anhui Province, China.

Stroke Center, Tongling People's Hospital Tongling, Anhui Province, China.

出版信息

Am J Transl Res. 2021 Jun 15;13(6):7132-7139. eCollection 2021.

Abstract

OBJECTIVE

To apply the emergency green channel integrated management strategy in intravenous thrombolytic therapy for acute ischemic stroke (AIS).

METHODS

This retrospective study involved a cohort of 82 AIS patients. Among them, 40 patients admitted to the emergency department of our hospital were treated using the emergency green channel integrated management strategy (the green channel group). Meanwhile, 42 AIS patients were rescued in accordance with the traditional grading and zoning treatment principles (the traditional group). The treatment times, the compliance rates of the times between when the patients entered the emergency department and when they underwent the thrombolysis treatment (the door-to-needle time or DNT), the neurological deficit scores, the Barthel index scores, and the ability of daily living scores before and after the treatment were compared between the two groups.

RESULTS

Compared with the traditional group, the triage times, the DNTs, the thrombolysis times, and the emergency department lengths of stay in the green channel group were significantly shorter (all P<0.001). The DNT compliance rate in the green channel group was significantly higher than it was in the traditional group (P<0.05). The neurological deficit scores in both groups after the treatment were lower than they were before the treatment (both P<0.01). The neurological deficit score in the green channel group after the treatment was lower than the neurological deficit score in the traditional group (P<0.01). The Barthel index and ability of daily living scores in the two groups after the treatment were significantly increased when compared with before the treatment (all P<0.001). The Barthel index and ability of daily living scores in the green channel group after the treatment were higher than they were in the traditional group (both P<0.001). The incidence of complications during the process of thrombolysis in the green channel group was significantly lower when compared with the incidence in the traditional group (P<0.05).

CONCLUSION

The emergency green channel integrated management strategy is more effective at shortening AIS patients' stays in the emergency department, increasing their DNT compliance rates, and at saving time for their thrombolytic therapy, improving patients' neurological function to a greater extent. It is worthy of clinical application.

摘要

目的

将急诊绿色通道综合管理策略应用于急性缺血性脑卒中(AIS)的静脉溶栓治疗。

方法

本回顾性研究纳入了82例AIS患者队列。其中,40例入住我院急诊科的患者采用急诊绿色通道综合管理策略进行治疗(绿色通道组)。同时,42例AIS患者按照传统的分级分区治疗原则进行救治(传统组)。比较两组患者的治疗时间、患者进入急诊科至接受溶栓治疗的时间(门-针时间或DNT)的达标率、神经功能缺损评分、Barthel指数评分以及治疗前后的日常生活能力评分。

结果

与传统组相比,绿色通道组的分诊时间、DNT、溶栓时间及急诊科住院时间均显著缩短(均P<0.001)。绿色通道组的DNT达标率显著高于传统组(P<0.05)。两组治疗后的神经功能缺损评分均低于治疗前(均P<0.01)。绿色通道组治疗后的神经功能缺损评分低于传统组(P<0.01)。两组治疗后的Barthel指数及日常生活能力评分与治疗前相比均显著提高(均P<0.001)。绿色通道组治疗后的Barthel指数及日常生活能力评分高于传统组(均P<0.001)。与传统组相比,绿色通道组溶栓过程中的并发症发生率显著降低(P<0.05)。

结论

急诊绿色通道综合管理策略在缩短AIS患者急诊科停留时间、提高其DNT达标率、节省溶栓治疗时间以及更大程度改善患者神经功能方面更有效。值得临床应用。

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