绿色通道管理策略在急性缺血性脑卒中患者静脉溶栓治疗中的应用  

Effect of green channel management on shortening intravenous thrombolysis time in patients with acute ischemic stroke

作　　者：黎春常[1] 张晓毛[1] 陈丽芳[1] 李冬欣[1] 周浩[1] Li Chunchang;Zhang Xiaomao;Chen Lifang;Li Dongxin;Zhou Hao(Guangdong Provincial People,s Hospital,Guangdong Academy of Medical Sciences,Guangzhou,510800,China)

机构地区：[1]广东省人民医院广东省医学科学院

出　　处：《现代临床护理》2019年第10期45-50,共6页Modern Clinical Nursing

基　　金：广东省医学科研基金项目，项目编号为A2014057

摘　　要：目的探讨绿色通道管理策略在急性缺血性脑卒中(acute ischemic stroke,AIS)患者静脉溶栓治疗中的效果。方法选择2016年6月至2017年9月本院急诊科实行分级分区救治的79例AIS患者为对照组;2017年10月至2019年3月本院急诊科实行分级分区联合脑卒中绿色通道救治的107例AIS患者为观察组,比较两组患者的急诊医生接诊时间、通知溶栓小组时间、溶栓小组就位时间、头颅电子计算机断层扫描(computed tomography,CT)完成时间、CT报告出具时间、AIS患者到达急诊至溶栓给药时间(door-to-needle times,DNT)和DNT时间达标情况。结果观察组患者的医生接诊时间、通知溶栓小组时间、溶栓小组就位时间、CT检查完成时间、DNT时间均短于对照组(P<0.01)。观察组患者DNT达标率高于对照组(77.6%vs 49.4%,P<0.01)。两组患者CT报告出具时间比较,差异无统计学意义(P>0.05)。结论实行分级分区基础上联合脑卒中绿色通道管理策略,可缩短AIS患者静脉溶栓时间,提高静脉溶栓效果。Objective To investigate the effect of green channel management on reducing the time of intravenous thrombolysis in patients with acute ischemic stroke(AIS).Methods A total of 79 AIS patients in the emergency department of our hospital from May 2016 to September 2017 were selected as the control group,and another 107 AIS patients in the emergency department from October 2017 to March 2019 were selected as the observation group.The control group was treated with grading and zoning management mode,and the observation group with green channel management.The two groups were compared in terms of the time for emergency doctor reception,time for thrombolysis group notification,time for thrombolysis group arrival,time for skull CT completion and report,door-to-needle time(DNT)of AIS patients from arriving emergency department to thrombolysis drug treatment and the achieved rate of DNT time.Results The time for emergency doctor treatment,time for thrombolysis group notification,time for arrival of thrombolysis group,time for skull CT completion and DNT time in the observation group were all significantly shorter than those of the control group(P<0.01).There was no statistical significance in CT report time between the two groups(P>0.05).The rate of qualified DNT time of the observation group was higher than that of the control group(77.6%vs.49.4%,P<0.01).Conclusion The implementation of grading and zoning management combined with green channel management is conducive to shortening the time from emergency to thrombolytic administration of AIS patients,and improving the effect of intravenous thrombolysis.

关 键 词：急诊 分级分区 绿色通道 缺血性脑卒中 溶栓 

分 类 号：R472.2[医药卫生—急诊医学]