基于院前预警系统开展的早期干预对缺血性脑卒中患者救治影响的前瞻性分析研究  

A prospective study on the impact of early intervention based on pre-hospital early warning system on the treatment of patients with ischemic stroke

作　　者：朱贵 胡金凤 肖维春 ZHU Gui;HU Jinfeng;XIAO Weichun(Shanghai Fengxian District Medical Emergency Center,Shanghai 201400,China)

机构地区：[1]上海市奉贤区医疗急救中心,上海201400

出　　处：《神经病学与神经康复学杂志》2022年第4期155-162,共8页Journal of Neurology and Neurorehabilitation

基　　金：上海市奉贤区科学技术委员会科学技术发展基金项目(20191407)

摘　　要：目的:研究基于院前预警系统开展的早期干预对缺血性脑卒中患者救治的影响。方法:入组由上海市奉贤区医疗急救中心接诊送往相应脑卒中中心的277例缺血性脑卒中患者,根据患者拨打120急救电话送入院前是否使用院前预警体系实施院前急救早期干预,将277例患者分为对照组(140例)和干预组(137例)。对2组的现场处置时间、入院至静脉溶栓治疗时间(door-to-needle time,DNT)、入院至股动脉穿刺时间(door to puncture time,DPT)、院前急救效果、并发症发生情况、预后情况进行比对。结果:干预组的现场处置时间、DNT、DPT时间均短于对照组,差异有统计学意义(P<0.001);干预组的转运成功率优于对照组,但差异不具统计学意义(P=0.574);干预组并发症总发生率低于对照组(P=0.036),预后情况优于对照组(P=0.028),差异均有统计学意义。结论:在应用院前预警系统的基础上开展院前急救早期干预可提升缺血性脑卒中患者急救效率,减少并发症的发生并改善患者预后。Objective:To study the impact of early intervention based on pre-hospital warning system on the treatment of patients with ischemic stroke.Methods:277 ischemic stroke patients received by Shanghai Fengxian district medical emergency center and sent to the stroke center were enrolled.According to whether the patients used the pre-hospital early warning system to implement pre-hospital emergency early intervention after dialing the 120 for emergency transport,277 patients were divided into the control group(140 cases)and the intervention group(137 cases).The on-site disposal time,door-to-needle time(DNT),door to puncture time(DPT),pre-hospital emergency effect,complication occurrence and prognosis of the two groups were compared.Results:Compared to the control group,the intervention group had shorter on-site disposal time,DNT and DPT(P<0.001).The successful rate of transfer was better in the intervention group than the control group,but the difference was not statistically significant(P=0.574).The overall incidence of complications was lower(P=0.036),and the prognosis was better(P=0.028)in the intervention group than the control group,and the differences were statistically significant.Conclusion:On the basis of applying the pre-hospital warning system,early intervention in pre-hospital emergency can improve the efficiency of emergency treatment for ischemic stroke patients,reduce the occurrence of complications,and improve patient prognosis.

关 键 词：缺血性脑卒中 院前急救 早期干预 入院至静脉溶栓治疗时间 入院至股动脉穿刺时间 

分 类 号：R743.3[医药卫生—神经病学与精神病学]