缩短院内延迟在缺血性脑卒中静脉溶栓治疗中的临床价值研究  

Clinic value of reducing in-hospital delay in patients with acute ischemic stroke after intravenous thrombolysis

作　　者：胡玉婷[1] 杨楠[2] 魏秀娥[1] 付家亮[1] 朱本亮[1] 荣良群[1] 杨华[1] 

机构地区：[1]江苏省徐州医学院第二附属医院神经内科,221006 [2]徐州医学院临床医学部

出　　处：《卒中与神经疾病》2014年第5期280-282,共3页Stroke and Nervous Diseases

摘　　要：目的：探讨通过卒中绿色通道建立,缩短院内延迟在急性脑梗死静脉溶栓治疗中的临床价值。方法收集2012年9月~2013年8月本科51例急性脑梗死患者接诊后进入卒中绿色通道,在4.5 h内接受重组组织型纤溶酶原激活物（rt-PA）静脉溶栓的急性脑梗死患者,评价就诊至溶栓时间,溶栓前、溶栓后2 h、14 d NIHSS 评分,溶栓后90 d mRS 评分,并分析危险因素与静脉溶栓预后的相关性。结果51例急性脑梗死患者从接诊至溶栓治疗的平均时间为（62.6±11.7）min,60 min 内接受溶栓治疗24例（47%）,44例完全或部分好转出院,院内延迟时间（DNT）〈62.6 min 组和〉62.6 min 组的 NIHSS 和 mRS 评分的差异明显（P 〈0.05）,即 DNT≤62.6 min 组预后较好。结论卒中绿色通道建立可有效缩短院内延迟时间,增加急性脑梗死患者溶栓治疗机会,具有较高的临床应用价值。Objective To explore the clinical value of reducing in-hospital delay in patients with acute is-chemic stroke after intravenous thrombolysis across establishing green channel.Methods 5 1 patients with a-cute ischemic strokes treated by recombinant tissue-type plasminogen activator within 4.5 h from symptoms onset were enrolled in this study.The door-to-needle time （DNT）,the National Institute of Health Stroke Scale （NIHSS）score at before thrombolysis therapy,2 h and 7 d after thrombolysis therapy were evaluated.Modified Rankin Scale score（mRS）were evaluated after 30 days.Investigating factors and favorable outcome.Results The median time of DNT was reduced to 62.6 1 1 .7 minutes in 5 1 patients.Proportion of patients presenting ≤60 minutes approved Intravenous thrombolysis was 47%.Hyptension is significantly associated with unfavor-able outcome.Conclusions By establishing green channel,reducing in-hospital delay can provide an opportunity to patients with acute ischemic stroke.

关 键 词：内延迟 脑梗死 静脉溶栓 卒中绿色通道 

分 类 号：R542.22[医药卫生—心血管疾病]