实施区域化协同救治网络对急性缺血性脑卒中救治效率的影响  

Effect of regional collaborative treatment network on treatment efficiency of acute ischemic stroke

作　　者：严金川[1] 邵晨[1] 陈蕊[1] 王翠平[1] 于明[2] 柯先金[2] 高琳[2] YAN Jinchuan;SHAO Chen;CHEN Rui;WANG Cuiping;YU Ming;KE Xianjin;GAO Lin(Department of Cardiology,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu 212001,China;Department of Neurology,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu 212001,China)

机构地区：[1]江苏大学附属医院心内科,江苏省镇江市212001 [2]江苏大学附属医院神经内科,江苏省镇江市212001

出　　处：《中国动脉硬化杂志》2021年第6期519-522,共4页Chinese Journal of Arteriosclerosis

基　　金：江苏省社会发展基金项目(BE2017699);江苏省医学创新团队项目(CXTDA2017010);江苏省青年医学重点人才项目(QNRC2016837);江苏省卫健委面上项目(H2018004)。

摘　　要：目的探讨区域化协同救治网络对急性缺血性脑卒中(AIS)救治效率的影响。方法以网络信息为核心,120急救为纽带,建立江苏大学附属医院所辖的8个社区医院AIS区域化协同救治网络。比较区域化协同救治网络实施前(实施前组,180例)、实施后(实施后组,218例)AIS的救治效率、治疗效果及经济学指标的变化。结果与实施前组相比,实施后组AIS患者时间窗内静脉溶栓比例明显提高(31.2%比2.8%,P<0.05),到院至静脉溶栓时间明显缩短[(58.7±11.3)min比(101.6±14.5)min,P<0.05],急诊45 min内完成头颅CT比例显著提高(61.9%比32.8%,P<0.05)。住院期间病死率实施后组低于实施前组(5.5%比8.3%,P<0.05)。与实施前组相比,实施后组住院天数明显缩短,住院费用明显减少(P<0.05)。与实施前组相比,实施后组1个月后日常生活能力评分(Barthel指数)显著增高,NIHSS评分明显降低(P<0.05)。结论实施区域化协同救治网络可明显提高AIS的救治效率,改善患者临床预后,降低经济负担,其是提升AIS救治能力的有效措施。Aim To explore the effect of regional collaborative treatment network on the treatment efficiency of acute ischemic stroke(AIS).Methods With network information as the core and 120 first aid as the link,the AIS regional collaborative treatment network of 8 community hospitals under the jurisdiction of Affiliated Hospital of Jiangsu University was established.The changes in AIS treatment efficiency,treatment effects and economic indicators before the implementation of the regional collaborative treatment network(pre-implementation group,180 cases)and after implementation(post-implementation group,218 cases)were compared.Results Compared with the pre-implementation group,the proportion of intravenous thrombolysis in the time window of AIS patients in the post-implementation group was significantly increased(31.2%vs.2.8%,P<0.05),and the time from admission to intravenous thrombolysis(door-to-needle time,DNT)was significantly shortened[(58.7±11.3)min vs.(101.6±14.5)min,P<0.05],the proportion of head CT completed within 45 min of emergency was significantly increased(61.9%vs.32.8%,P<0.05).The mortality rate during hospitalization was lower in the post-implementation group than the pre-implementation group(5.5%vs.8.3%,P<0.05).Compared with the pre-implementation group,the number of hospitalization days in the post-implementation group was significantly shortened,and hospitalization expenses were significantly reduced(P<0.05).Compared with the pre-implementation group,the daily living ability score(Barthel index)after 1 month in the post-implementation group was significantly increased,and the NIHSS score was significantly decreased(P<0.05).Conclusion The implementation of regional coordinated treatment network can significantly improve the treatment efficiency of AIS,improve the clinical prognosis of patients,and reduce the economic burden.It is an effective measure to enhance the treatment ability of AIS.

关 键 词：区域化协同救治网络 急性缺血性脑卒中 救治效率 

分 类 号：R743[医药卫生—神经病学与精神病学] R5[医药卫生—临床医学]